Urolithiasis disease(other names: urolithiasis, nephrolithiasis, nephrolithiasis disease) occurs in approximately 12 percent of men and 5 percent of women aged 70 years. Fortunately, in most cases, urolithiasis responds well to treatment. In addition, there are measures to prevent relapse of this disease that are available to every patient.

Urolithiasis: symptoms, diagnosis and treatment

Causes of urolithiasis (how kidney stones form)

The occurrence of kidney stones (calculi) can occur both with increased and normal levels of calcium, oxalic acid compounds (oxalates), cystine, and uric acid in the urine. All these substances form crystals, which are fixed in the structures of the kidney and gradually increase in size, forming stones.

In a typical case, such a stone begins to move through the urinary tract and is excreted from the body in the urine. But when a stone gets stuck in the urinary tract and obstructs the flow of urine, it can cause pain. Large stones do not always pass away spontaneously, and in some cases surgical intervention is required to remove them.

Symptoms of urolithiasis

Pain— The most common sign of urolithiasis is pain, which can vary from mild, barely noticeable, to intense, difficult to bear and requiring medical intervention. As a rule, the pain intensifies and then subsides, but does not go away completely. Typically, the bursts of severe pain known as renal colic last between 20 and 60 minutes. The pain may be localized in the side (in the iliac and lateral regions) or in the lower abdomen.

Blood in urine- Most patients have blood in their urine ( hematuria). Urine may be pink or reddish, but sometimes blood can only be detected using a rapid urine test (test strips). urine dipstick testing) or microscopy.

Sand in urine— “Sand” or small stones may be found in the urine of patients.

Other symptoms— Other signs of urolithiasis include nausea and vomiting, pain when urinating, or a sudden urge to urinate.

Asymptomatic urolithiasis— Often, urolithiasis occurs without obvious symptoms. In such cases, stones in the kidneys or urinary tract are discovered by chance, during examination for another reason using imaging methods of instrumental diagnostics (ultrasound, X-ray, computed tomography). Stones can remain in the kidneys for many years without causing any symptoms.

Diagnosis of urolithiasis

Typically, kidney and urinary tract stones are detected based on the patient's symptoms, physical examination, and imaging tests.

Computed tomography (CT)— Using computed tomography, a three-dimensional image of the internal structures of the body is obtained. Often, if urolithiasis is suspected, an imaging diagnostic method such as non-contrast spiral computed tomography (noncontrast helical C.T.).

Ultrasound— Ultrasound can also be used to detect stones, although this makes it difficult to diagnose small stones and ureteral stones. However, ultrasound examination ( Ultrasound) is strongly recommended for those patients for whom radiation is contraindicated, for example, pregnant women.

The choice of treatment technology depends both on the size and location of the stones, as well as on the nature of the pain and the patient’s ability to take fluid. If the most likely outcome is spontaneous stone passage, the patient can eat and drink independently, and the pain is tolerable for him, then he can be treated at home.

However, in cases where the patient experiences severe pain or nausea, it is necessary to take effective painkillers and intravenous infusions, which can be provided in a specialized medical facility.

Treatment of urolithiasis at home— During the passage of the stone, the patient can take painkillers sold without a prescription: non-steroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin) or naproxen (Aleve). The recommended doses of these drugs are indicated on the packaging.

Other medications may also be prescribed, such as nifedipine (Procardia®) or tamsulosin (Flomax®), accelerating the process of stone passage.

The patient may be asked to filter a sample of their urine to obtain stone samples for later analysis in a laboratory where the chemical composition of the stone (eg calcium, uric acid, etc.) will be determined. Understanding what type of stones are is important for planning subsequent preventive treatment.

If the stones do not pass spontaneously— Stones larger than 9 or 10 millimeters rarely pass away on their own. As a rule, special procedures are required to destroy or remove such a calculus. Exists whole line available technologies for such treatment.

Shock wave lithotripsy, SWL (shock wave lithotripsy , SWL ) — Lithotripsy is the treatment of choice for many patients who require medical assistance to pass stones. Lithotripsy is especially recommended for patients with stones located in the kidney or proximal (upper) ureter.

Lithotripsy is not always effective in the presence of large or heavy stones. You may need to use sleeping pills or painkillers during the procedure, although this depends on the type of equipment (model of lithotripter) used for lithotripsy.

Lithotripsy is performed by focusing a high-energy shock wave onto the kidney stone. This “shock” wave, passing through the skin and tissue, releases its destructive energy at the surface of the calculus, leading to its fragmentation into fragments capable of easier passage through the urinary tract.

Percutaneous (percutaneous) nephrolithotomy (percutaneous nephrolithotomy , PNL ) — Minimally invasive endoscopic surgery called percutaneous nephrolithotomy may be required to remove extremely large or composite stones, as well as stones that are resistant to shock wave lithotripsy. During this procedure, small instruments are sequentially inserted into the kidney through a small puncture in the skin to create and widen the nephrostomy channel, fragment and remove stones.

Urethroscopy (URS) Urethroscopy is a procedure that uses a thin tube passed through the urethra (urethra) and bladder into the ureter and kidney. This tube is urethroscope- contains a camera and other instruments that allow the doctor to see stones, remove them, crush them into small pieces that can pass relatively easily through the urinary tract. Urethroscopy is often used to remove stones blocking the ureter and, in some cases, for kidney stones.

Treatment of asymptomatic urolithiasis— If a patient has urolithiasis that occurs without pronounced symptoms, he should decide on the advisability of treating this disease. In this case, one should take into account both the size and localization of stones, and the possibility of emergency contact with a medical institution in case of acute development of symptoms.

Regardless of the patient’s decision - whether to undergo treatment or not - it is necessary to assess his state of health for the presence of diseases that increase the risk of developing urolithiasis.

Prevention of urolithiasis

If you have stones in the kidneys or urinary tract, you should get blood and urine tests to look for possible health problems that contribute to the development of urolithiasis.

Discarded stones found should be analyzed to determine their type. Based on the results of this study, some of the following recommendations can be made:

• You may be prescribed a drug to reduce your risk of stone formation in the future.
• If you want to reduce the likelihood of other stones, drink more fluids to increase the volume of urine flowing through the kidneys and reduce the concentration of substances that stimulate stone formation. There is a recommendation to drink enough fluid per day so that the volume of urine excreted is about 2 liters per day.
• Depending on the type of stones found, you may be advised to make certain dietary changes.

Summary

• The occurrence of kidney and urinary tract stones can occur with both elevated and normal levels of certain substances in the urine that can form crystals. The crystals are fixed in the kidney and gradually increase in size, forming a stone (calculus).
• Typically, over time, this stone moves through the urinary tract and is passed in the urine. Otherwise, it remains in the urinary tract, obstructing the flow of urine, which can cause pain.
• Some diseases, lifestyle features and a number of other factors increase the risk of developing urolithiasis in a particular person. Such risk factors include cases of urolithiasis in the past in the patient or his family members, some features of the usual diet, concomitant diseases, taking certain medications, and dehydration.
• The most common sign of urolithiasis is pain. Other symptoms include hematuria (blood in the urine), passing small stones, nausea, vomiting, pain when urinating, and an uncontrollable urge to urinate. Some patients have no symptoms.
• Tests are usually required to diagnose urolithiasis. Computed tomography (CT) is the diagnostic modality of choice for most patients.
• Treatment of urolithiasis usually consists of relieving pain and increasing fluid intake (drinking) until the stones pass. This is also where over-the-counter pain medications (such as ibuprofen, Advil, Motrin). If the pain is severe and uncontrollable, you may need to use a more effective medication (for example, one of the narcotic analgesics).
• Small stones (less than 5 millimeters) usually pass out in the urine on their own, without treatment. Larger stones (over 9 millimeters) are less likely to pass spontaneously; in such cases, treatment is usually carried out in a medical facility.
• For patients who have had urolithiasis more than once during their lifetime, additional examination is recommended to determine whether the formation of kidney stones is associated with any disease. Medications may be prescribed to prevent subsequent stone formation. In some cases, drinking plenty of fluids and changing your usual diet can help prevent further stone formation.

Urolithiasis in women, as well as in men, is a fairly common disease, which is manifested by the formation of stones with varying salt content in them in the area of ​​the kidneys, bladder, and ureters. This disease most often affects the male part of the population, but the female part does not go unnoticed by this pathology. In the international classification, acute urolithiasis ICD 10 is also divided depending on the location of stones (stone-like formations) into N20 and N23.

Causes of urolithiasis

The occurrence of urolithiasis is associated with the influence of many factors. In modern society, this disease is quite common, as a sedentary lifestyle predominates, leading to stagnation and disruption of microcirculation. These are also common nutritional errors. The main reasons for the development of urolithiasis are:

• Genetic predisposition. That is, the presence of similar metabolic disorders in close relatives;
• Anomalies in the development of organs of the urinary system (double kidney, single kidney, etc.);
• Violation of the drinking regime (drinking a small amount of water, or drinking water rich in mineral salts);
• Systematic errors in nutrition. This occurs with frequent consumption of fatty, salty, spicy foods, a large number of protein, increased concentration of canned food in the diet;
• Disorders of metabolic processes in the body;
• Physical inactivity;
• Chronic diseases of the gastrointestinal tract.

Each of the reasons, as a rule, is combined with a number of others. It is also important for the patient to ignore any problems for a long time, because the formation of calculi (stones) occurs over a certain rather long period of time. With timely elimination of predisposing factors, the appearance of such a diagnosis as urolithiasis, patient reviews of which are very sad, can be avoided.

Symptoms

Urolithiasis in men, as well as women, is not always accompanied by severe symptoms. There are cases when the disease does not manifest itself in any way and is detected by chance, during a preventive examination. But, as a rule, there are the following clinical manifestations:

• Pain when urinating. The pain is located in the area above the pubis and goes away after the process of urine excretion is completed.
• Pain along the ureters when changing body position, lifting weights, or physical impact on the organs abdominal cavity.
• The occurrence of pain during an objective examination by a doctor (a symptom of effleurage in the lumbar region in the area where the kidneys are located).
• Changes in the color of urine, its transparency, and possible appearance of blood.

These clinical manifestations are practically initial, that is, characteristic of those stages of the disease when there are no pronounced disorders in the tissues of the kidneys or ureters. Also, the manifestations of the disease depend on the size of the formed stone and its composition, that is, from what type of salts it is formed.

In the case when a stone with a current of urine begins to move as a result of a spasm of the urinary tract, stagnation of urine develops, which causes severe unbearable pain - renal colic. This pain usually radiates to the groin area, thigh, and the pain can spread throughout the abdomen. In such a situation, when stones pass out due to urolithiasis, vomiting, nausea, chills, increased body temperature may also appear, and of course, a violation of the act of urination, it becomes sharply painful, or even impossible.

As mentioned above, urolithiasis of the kidneys (in women and men), or rather, the clinical picture of the disease depends on the size of the stones and the salts from which it is formed. There are salts that are often found in the composition of such formations - oxalates. They look like uneven gray stones with spiny processes, which in the process of passing through the urinary tract can significantly injure the mucous membrane. Phosphates are less common than the previous ones, and have the appearance of smooth stones that are easily destroyed. And stones formed by urate salts are the least common, and look like a smooth brick-colored piece.

The size of such a stone, up to one centimeter, has every chance of independently passing through the urinary tract and exiting the body. If the size is more than one centimeter, intervention is necessary.

Treatment methods

After carefully collecting data and conducting a clinical and laboratory examination, the doctor makes a decision on the necessary treatment method in each specific case. The following treatment methods are available:

• Conservative management, both in the case of small stones and in the case of renal colic;
• Surgical treatment by removing the stone;
• Destruction of small stones;
• Crushing of large stones and further management conservatively.

As a result, the code of the disease urolithiasis, ICD code 10, is set according to the location of the pathological process itself.

Prevention of relapses after urolithiasis

This disease, if it occurs, even after successful treatment, is prone to resumption of the process. Therefore, in order to prevent the occurrence of urolithiasis in principle, or repeatedly, the following measures are necessary:

• Introduce adequate physical activity into your daily routine.
• Adhere to a balanced diet, exclude foods that lead to metabolic disorders and diseases of the gastrointestinal tract.
• Conduct timely treatment of diseases of the urinary system.
• Visit sanatoriums for urolithiasis (ICD code 10), which rarely recurs and gives a very positive effect.

On the topic of sanatoriums, there is a common question: is it possible to undergo sanatorium-resort treatment for urolithiasis? During periods of exacerbation of the disease, the presence of stones and other acute conditions, sanatoriums are contraindicated. But in case of successful treatment, according to the doctor’s indications, this prevention and recovery is recommended, the main thing is to establish the causes of the disease and eliminate them. Which we will talk about next.

Causes

The paths of development of this disease are diverse and depend on many factors. The main cause of stone formation is congestion in the kidney parenchyma. But this process is driven by many other common factors.

Urolithiasis causes of the disease

External factors

Modern society is characterized by types of work that do not require physical effort, which leads to physical inactivity and long-term stagnant processes in the body. This is one of the first reasons that leads to the development of urolithiasis. But none of the causes of the disease is single; as a rule, it is a combination of several.

Also among the factors contributing to urolithiasis is poor nutrition, which can also be associated with the modern rhythm of work and social standard of living. Thus, systematically eating smoked, hot, spicy, fatty and fried foods, as well as excessively salty foods and canned food, large amounts of meat and protein of plant origin can easily lead to disruption of metabolic processes in the body. With this diet, diseases of the gastrointestinal tract occur, which lead to metabolic disorders. Which subsequently are the causes of urolithiasis in women and men.

In addition to a violation of the diet, a risk factor for the development of this disease is a violation of the drinking regime, as well as the qualitative composition of the consumed liquid. The point is that it is not recommended to abuse waters that are rich in various mineral salts. A decrease in the amount of water consumed per day also contributes to the development of the disease. This leads to the same stagnant processes and accumulation of salts in the urinary system.

Internal factors

One of the important risk factors is congenital anomalies of the urinary system (double kidney, single kidney, double ureter or bladder, or absence of any of the ureters).

The presence of diseases associated with metabolic disorders, such as gout, hyperparathyroidism.

Infectious diseases of the urinary tract, especially often recurrent. In this case, the pathogen itself is not particularly important. Although, pathogens that cause sexually transmitted infections can also affect the urinary system, causing more harm compared to other infections.

Also, as stated above, the reason why urolithiasis occurs is the development of severe chronic diseases such as hepatitis, gastritis, pancreatitis and others.

Most often, risk factors and causes of urolithiasis are combined with each other, which leads to a faster development of the disease.

Pathogenesis of disease development

The root of the whole problem lies in the development of stagnation in the urinary system. These processes are usually combined with damage to the buffer systems in which filtration processes occur in order to release free crystals. This occurs at the moment of formation of urine itself in the nephron tubules with its subsequent removal from the body. As a result, there is a risk that the saline solution will transform into crystals, which are called calculi or stones, as they have a characteristic appearance similar to natural minerals. Thus, urolithiasis is formed, the causes of which we have examined.

When a stone has already formed, but is small in size, it may not give any symptoms, that is, there will be no manifestations. Meanwhile, the stone increases in size and grows. At the moment when the formed stone begins to move through the urinary system down the ureter into the bladder, it is called nephrolithiasis. It is this condition that often causes vivid manifestations in the form of pain - renal colic.

Men are most susceptible to developing this disease. The causes of urolithiasis in men arise as a result of their anatomical features of the structure of the urinary system. According to statistics, women suffer from urolithiasis much less often than men, but in general, the causes of urolithiasis in women are the same as in men.

Urolithiasis: causes, treatment

It should be noted that the reasons for the development of urolithiasis are the starting point for the treatment of this disease. That is, depending on what caused the disease, the method of treatment and further management of the patient, as well as a number of preventive methods to prevent relapses, depend. In order to adequately provide assistance, a complete diagnosis is necessary, the methods of which will be discussed in the next article.

Symptoms and features of treatment of urolithiasis

Urolithiasis is considered one of the most common urological diseases. Men are more likely to suffer from it, but women can also develop it due to certain circumstances. People aged 30 to 50 years are at risk. Therefore, it is necessary to always remember the features of this disease and its main symptoms.

What is urolithiasis?

Urolithiasis is the process of formation of stones in the urinary tract, kidneys and bladder. Such deposits are formed from substances that make up urine. The disease is chronic.

For young people, the formation of stones in the bladder is common. In the older generation, the problem is more often diagnosed in the ureters and kidneys. Experts have not been able to fully understand the mechanism of development of the disease. It is known that the likelihood of the disease increasing for people living in regions with unfavorable environmental conditions.

Types of urolithiasis

The problem can be classified according to several criteria. The main one is the composition of sediments. The following varieties are distinguished:

1. Phosphates. The stones consist of salts of phosphoric acid.
2. Oxalates. Formations are formed from oxalic acid.
3. Urate. Stones are formed from uric acid salts.
4. Protein. Proteins play a key role in the formation of stones.

Most often, a mixed type of formation is diagnosed. Based on the characteristics of the stones, a therapy technique is developed.

If we consider the problem from the point of view of the characteristics of the course of the disease, the following forms are distinguished:

1. Primary. In this case, the formation of stones is not associated with internal factors of the body, for example, prostate adenoma or impaired blood supply to the kidneys.
2. Secondary. The formation of stones occurs under the influence of internal factors. This leads to disruption of the outflow of urine from the kidneys.

Successful treatment of the disease is possible only if the provoking factor is identified. It is necessary to determine whether there is a problem as early as possible.

Symptoms

The following symptoms will help to identify the disease in a timely manner:

1. Pain in the lumbar region, scrotum, hypochondrium or perineum, which is paroxysmal in nature. They are caused by a problem with the outflow of urine associated with blockage of the urinary tract. Pain may occur after drinking too much liquid or shaking violently. They are accompanied by attacks of nausea and vomiting, and frequent urge to urinate. At the same time, the person becomes irritable. Such an attack can last from several hours to days.
2. Traces of blood are found in the urine. This phenomenon is called hematuria. It is detected in 92% of cases. Blood entering the urine is caused by damage to the veins of the fecal plexuses.
3. Development of the infectious process. It may manifest itself in the form of chronic pyelonephritis. The situation can be aggravated by the active proliferation of streptococcus, E. coli or staphylococcus. In the absence of proper treatment, bacteriological shock may develop.
4. In some cases, spontaneous passage of small stones is possible.

Such signs indicate the development of urolithiasis. If they are detected, you must immediately undergo a medical examination. Only a specialist can develop an adequate treatment program.

The main causes of the disease

The development of urolithiasis can be influenced by several factors. They can be divided into three main groups: exogenous, endogenous and local.

Among the exogenous, that is, external causes, the following can be distinguished:

1. Poor nutrition. Excessive consumption of sour and spicy foods affects the acidity of urine.
2. Difficult working conditions. People who work in hazardous work often suffer from urolithiasis, as well as those whose activities involve heavy physical labor.
3. Climatic conditions. Ultraviolet radiation has a negative impact elevated temperature air.
4. Sedentary lifestyle.
5. Poor quality drinking water. The formation of stones is promoted by drinking water with a high concentration of calcium salts.

Endogenous causes develop within the body. Among them are:

1. Increased activity of the thyroid gland.
2. Gastrointestinal diseases that are chronic.
3. Deviations in liver function.
4. Insufficient production of enzymes.
5. Injuries of the musculoskeletal system.

A number of local factors can be identified that contribute to the development of urolithiasis:

1. Increased kidney size due to obstruction of urine passage.
2. Prostate adenoma.
3. Pyelonephritis or other inflammatory processes in the kidneys.
4. Impaired blood supply to the kidneys due to injury.

Only after determining the cause of the disease can a specialist develop the correct treatment program. Therefore, the sooner you seek help, the greater the chances of a quick cure.

Accurate diagnosis

A specialist can make an accurate diagnosis only by conducting a comprehensive examination of the patient. It includes the following activities:

1. Collection and analysis of symptoms and the course of the disease. The doctor pays attention to how long ago the pain has appeared, the presence of blood in the urine, as well as accompanying symptoms.
2. Studying the characteristics of the patient’s lifestyle. The specialist needs to find out in what environmental situation the person lives, who he works for, his diet, and so on.
3. Tactile inspection. The doctor palpates and lightly taps the kidney area. The patient's reaction to such an effect is determined.
4. General blood analysis. It is prescribed to determine the ESR, as well as the presence of a shift in the leukocyte formula.
5. Analysis of urine. The study determines the presence of red blood cells and salts in the urine.
6. Cystoscopy is an examination of the bladder using a specialized device.
7. Ultrasound. The condition of the kidneys and bladder is examined. This allows you to determine their size, structure, and also identify the presence of deposits. In addition, it is possible to examine the enlargement of the urinary tract.
8. X-ray of the entire abdominal cavity.
9. Excretory urography. Examination of the kidneys and ureters using X-rays. For greater information, a contrast agent is injected into the human blood.
10. Dynamic scintigraphy. Radioactive substances are introduced into the human body. After which a series of photographs is taken. This helps to identify a violation of the outflow of urine.
11. CT scan. The study is carried out after the administration of a contrast agent. Such a study allows you to take pictures in different projections, which helps to study the condition of the organs in detail.

Such studies will reveal the exact cause of the problem and the extent of the damage. Only after this will it be possible to develop a treatment method.

Basic principles of therapy

Conservative treatment of urolithiasis involves the use of the following methods:

1. Taking medications designed to reduce the concentration of uric acid in the blood, as well as changing the urine environment. Additionally, a course of B vitamins is prescribed, as well as various diuretics. The use of uroantiseptics helps fight microbes in the kidneys.
2. Dietary diet. It is necessary to reduce the consumption of fatty and salty foods, and also completely avoid alcoholic beverages.
3. Drinking enough liquid. You need to drink at least 2.5 liters of clean water per day.
4. Physiotherapy.
5. Physiotherapy.

An important part of the treatment is cleansing the body of formed stones. To do this, use the following methods:

1. The use of drugs that normalize the physical and chemical parameters of urine. Thanks to this, small stones are removed.
2. Abdominal surgery. Removal of large stones as a result of abdominal surgery.
3. Laparoscopy. This is a procedure to remove stones through small incisions.
4. Lithotripsy. Stones are crushed using ultrasonic or x-ray waves.
5. Transurethral method. A special tube is inserted through the urethra, at the end of which a camera is installed.
6. Ureterolithotripsy. Destruction of stones using a laser.
7. Percutaneous nephrolitholapaxy. A passage with a diameter of no more than 1 cm is created in the area of ​​the renal collecting system of the kidney. Stones are removed through it.

The choice of a specific technique is carried out by a specialist, based on the patient’s health condition and the individual characteristics of his body.

Possible complications

Often, urolithiasis provokes the development of complications. Among them are:

1. Hypertrophic cystitis in chronic form. Appears in cases where a large stone long time was in the bladder.
2. Chronic pyelonephritis. Inflammation of the kidneys caused by a bacterial infection.
3. Acute pyelonephritis. Sudden onset of kidney inflammation. In severe cases, pyonephrosis can form - a purulent formation on the kidney.
4. Kidney failure. Impaired kidney function.

In order to prevent the development of such complications, it is necessary to identify the problem as early as possible and begin treatment.

Preventive actions

In order to prevent the occurrence of urolithiasis, you must adhere to the following recommendations:

1. Drink more clean drinking water.
2. Move more.
3. Control your body weight and eliminate unhealthy foods from your diet.
4. Promptly identify and treat all kidney and bladder diseases.
5. To refuse from bad habits.

Diagnostics

Urolithiasis is a rather complex and serious disease that poses a threat to a person’s health and full life. And sometimes it can even threaten life, in the case of damage to a single kidney, or an advanced bilateral process. In order to determine the extent of damage to the urinary system, or even to differentiate this pathology from any other, a thorough diagnosis is necessary in order to make a diagnosis and provide adequate care and treatment to the patient.

Any diagnostic measures are based on the collection of complaints, data from an objective examination by a doctor, instrumental and laboratory research methods. Likewise, urolithiasis diagnostic methods include the same.

Patient complaints

Patient complaints form the basis on which, one by one, other diagnostic data indicating urolithiasis are layered. The most common complaint with urolithiasis is pain. Severe pain when a stone moves along the urinary tract, which is located in the abdominal cavity along the ureters and spreads to the hip area on the affected side, to the lumbar region, to the groin. With a bilateral process, the pain spreads symmetrically. The pain syndrome forces the patient to rush from corner to corner in search of a body position in which he can feel relief. Such attacks of pain may be accompanied by nausea, vomiting, fever, and chills. Also, one of the manifestations characteristic of urolithiasis is a violation of urination: the presence of frequent false urges, a feeling of incomplete emptying of the bladder, frequent and painful acts of urination. Such symptoms already suggest the manifestation of the pathology of urolithiasis, diagnosis, treatment of which is just beginning.

Objective examination

Usually, similar symptoms force the patient to seek medical help and here the matter is in the hands of specialists. The doctor assesses the general condition of the patient, the color of the skin, and his forced position. Performs palpation of the abdominal cavity, a symptom of tapping in the lumbar region and identifies the presumptive lesion. This is followed by laboratory and instrumental diagnostics.

Urolithiasis: what tests to take

First of all, a clinical blood test is performed for urolithiasis, which reveals signs of the inflammatory process in the form of an increase in ESR and the occurrence of leukocytosis, that is, an increase in the number of leukocytes in the peripheral blood. Then, in the pathology of urolithiasis, blood biochemistry indicates the immediate focus of the disease. If the study shows elevated levels of urea, creatinine and uric acid, such data indicate a process of obstruction of the urinary system. Also, during a biochemical study, it is possible that protein in urolithiasis will be underestimated.

The composition of electrolytes is determined in the blood serum, which is taken from a vein. There is an increase in the number of calcium and phosphorus ions, and a decrease in magnesium ions.

A mandatory study is a urine test for urolithiasis, the indicators of which will be as follows. Protein appears in the urine in increased levels, an increase in the number of leukocytes, the appearance of red blood cells, salts of increased concentration, and bacteria. It is also necessary to examine additional urine parameters for urolithiasis. For this purpose, a Nechiporenko or Amburge test is performed to determine the content of leukocytes in 1 ml of urine.

Instrumental diagnostics

Until a certain point, cystography was widely used for diagnostic purposes, but at the moment it has lost its diagnostic position.

Instrumental diagnostics includes a number of examinations. Ultrasound of the urinary system ranks first in terms of accessibility and speed of the method. But X-ray examination is more diagnostically significant in determining urolithiasis. Not in all cases, a simple x-ray can be informative, since such types of stones as urate, xanthine and cystine are not visible on the image. Although these types of stones are quite rare, they, like all other similar conditions, require diagnosis. Therefore, excretory urography is used, in which the functional state of the kidneys and their structural changes are determined from the contrast agent detected on the X-ray image, which moves along the urinary tract. And also, if a patient has a defect in filling with a contrast agent on the image, but a stone is not detected, therefore, in this case there is an X-ray negative stone.

If the above methods do not give accurate results, or differential diagnosis of urolithiasis is necessary, the next step in the table of a number of instrumental methods is radionuclide diagnostics and computed tomography.

Radionuclide diagnostics is based on the recognition of urolithiasis. Moreover, this type of study makes it possible to determine the functionality of the kidneys, namely the tubules and glomeruli of the kidney apparatus. A particularly important point in the radionuclide method in patients with urolithiasis from the point of view of frequent recurrence of the disease is the determination of the amount of parathyroid hormone produced by the parathyroid gland. This analysis is obtained from the veins of this gland.

If, in order to apply treatment to the patient in the form of lithotripsy, the structure, exact location and density of the stone should be clarified, computed tomography is used. The density of a stone depends on its chemical composition and physical structure.

And so, in order to find out what tests for urolithiasis in women, and even men, you need to contact a specialist who will make all the necessary appointments.

Treatment

Today, there are many methods that form a comprehensive treatment for urolithiasis in men and women. Each specific case is considered individually and, accordingly, adequate treatment is selected.

Basic principles of treatment of urolithiasis

As a rule, when a patient is diagnosed with urolithiasis, he complains of severe pain, based on this, first of all, analgesic and antispasmodic therapy is carried out. This treatment is carried out to alleviate the patient’s condition and relax the spasmodic muscle layer of the urinary system.

And so, the basic principles by which patients suffering from this disease are treated include:

• The process of destruction or grinding of a calculus (stone);
• Removing stones from the urinary system (surgically or naturally along the urinary tract);
• Prevent stone formation in the future by eliminating the reasons why this pathology arose;
• The use of a variety of drug treatments to sanitize the urinary system and eliminate the bacterial source of inflammation.

Treatment of urolithiasis in women and men: methods

It is also possible to divide the treatment into the following methods used today that modern medicine offers in relation to urolithiasis:

• The first method can be considered conservative. It is based on drug treatment and is used when the size of the stone is up to one centimeter, as well as taking into account the natural removal of the stone from the body;
• The symptomatic treatment method is used for renal colic, when the primary goal is to alleviate the patient’s suffering and improve his general condition;
• The most common is the surgical method. Used in cases of multiple stones and large sizes. In this case, both the stone itself and the stone containing the kidney can be removed;
• More gentle treatment methods include medicinal litholysis, local litholysis;
• A percutaneous nephrostomy is performed;
• Removal of stones that have descended into the ureter using the instrumental method;
• Aspiration (suction) removal of stone that has previously been destroyed;
• Destruction of stones by contact ureteroscopy;
• And the most modern and minimally invasive method is extracorporeal lithotripsy. In this case, a shock wave focus is used, which is created by a device outside the body and is aimed directly at the formed stone.

Let's take a closer look at some of the modern methods of treating urolithiasis.

Surgical method

The main method of treating this problem, despite modern methods, still remains surgical. This is the leading direction in how to treat urolithiasis in humans. Indications for this type of treatment are complications that arise as a result of blockage of the urinary tract, resulting in the development of anuria - lack of urine. Also, a direct indication for urgent surgical treatment is renal bleeding and obstructive pyelonephritis.

There are also relative indications that can lead the patient to the operating table. Such indications include frequent episodes of renal colic, even in the case of preserved kidney function, and chronic calculous pyelonephritis with an ever-increasing spasm of the “cavity” of the kidney. When performing a surgical intervention, which is otherwise called pyelolithotomy, anterior and inferior, posterior and superior access is used in relation to the poles of the kidney and the location of the calculus. Posterior pyelolithotomy is most often used. But, unfortunately, there are complications of this type of treatment. There is a high risk of relapse. If the disease recurs, significant difficulties arise, and repeated surgery has a high risk of death.

Conservative treatments for urolithiasis

Conservative treatment has a number of advantages and has nothing to do with surgical incisions. But there is no completely developed methodology for its implementation, and its effects, in fact, are only aimed at eliminating pain and relieving spasms. Although, the main idea of ​​this treatment is to remove the stone naturally only with the help of medications. But this treatment option has the right to life, because urolithiasis is eliminated, assistance is provided not only to remove the stone, but also to relieve pain, which together, in a certain clinical situation, gives a positive effect. In this case, drugs are used for urolithiasis of the kidneys, antispasmodic and analgesic.

Current Treatment Options

Endoscopy occupies a leading place in modern medicine. And, of course, this method has not bypassed the treatment of urolithiasis. There are methods of endoscopic treatment that have gained popularity due to their low invasiveness:

• The method of ureteroscopy, with the help of which a special device called a ureteroscope is used to penetrate the kidney through the urethra, rising up. After which the stone is crushed into smaller ones and then removed;
• Nephroscopy. Access is made through the skin, the renal pelvis is expanded, where a specialized device (nephroscope) is inserted, and, as in the first case, the stone is destroyed and removed;
• And the most gentle and popular method is the method of remote lithotripsy through shock wave exposure.

Injections for urolithiasis, home medications

Patients often ask whether it is possible to treat urolithiasis at home? Treatment at home is strictly contraindicated. There is a possibility of an acute condition occurring when the patient himself is not able to assess the severity of the situation, unlike specialized medical personnel, and seeking medical help may not be timely. But most often, patients still carry out home treatment for urolithiasis in women on their own, looking for medications via the Internet or on the advice of a neighbor. Do not pay attention to what others take for urolithiasis, and do not risk your health, but rather seek medical help, where, among painkillers and antispasmodics, corrective targeted herbal medicine, for example, the drug phytolysin, will be carried out. Read about its properties and effect on the body in this pathology in the following article.

Phytolysin

Treatment of urolithiasis is multifaceted and is aimed at eliminating pain, spasm, the stone itself, restoring a satisfactory general condition and normal functioning. Often the main line is antispasmodics (spasmalgon, spazgan, no-shpa and others), painkillers (dexalgin, ketanov, ketorol and others), antibiotics of various groups. But herbal medicine also makes a significant contribution to treatment and to prevent relapses of the disease. Let's consider one of the most popular and effective herbal remedies, phytolysin.

The drug phytolysin

One of effective means For the prevention of urolithiasis and for complete comprehensive treatment, the modern herbal herbal medicine phytolysin is used. It has a number of certain effects and effects: it reduces the inflammatory process, has an analgesic property and relieves spasm of the smooth muscles of the entire urinary system, and also has an antimicrobial effect. It has an effect on the removal of small stones and so-called sand from the kidneys, ureters, or even the bladder.

Phytolysin, in its composition, contains many herbs, such as: onion peels, parsley fruits, bird knotweed, wheatgrass root, horsetail, birch leaves, harvest seeds, goldenrod, parsley leaves, lovage. Each herb has its own effect.

For example, parsley herb can increase the tone of the muscular component of the walls of the bladder, has a disinfectant effect, and also affects general sedation, and, of course, cannot do without a diuretic effect. Wheatgrass and onion peel are aimed at antimicrobial action and resumption of metabolic processes.

Essential oils are an important component of many drugs from pharmaceutical companies in the fight against kidney diseases, and naturally they are also added during the production of phytolysin. They are able to influence the process of removing stones and relieve inflammation.

The medicine (phytolysin), due to its components, is more conveniently produced in the form of a paste mixture, which is taken orally (regardless of food intake) one teaspoon, diluted in one hundred milliliters of water three to four times a day. The course of taking phytolysin ranges from two weeks to one and a half months. Many experts note the positive effect of treatment with phytolysin.

But, like all herbal remedies, phytolysin has its own contraindications. If the patient has phosphate kidney stones, acute renal and/or liver failure, cholelithiasis, or heart failure, the drug is contraindicated for use.

After phytolysin was used for urolithiasis, patient reviews were very positive. Typically, patients describe that after weeks of use, the pain symptom that had previously disturbed their general condition decreases, the process of urination becomes easier, and the quality of life increases. Thus, herbal medicine for urolithiasis, after using phytolysin, patients even note the spontaneous release of stones.

Use of other drugs

Phytolysin is not a drug of choice in the treatment of urolithiasis, that is, without the use of other medicines not enough. The basis of any treatment for urolithiasis includes drugs with antibacterial properties, since bacterial inflammation is present in this pathology. It is also possible for the infectious process to spread in a descending manner, that is, the risk of developing a disease such as cystitis with urolithiasis is quite high.

The most popular of them in urological practice are furagin, furadonin and furamag. All these antibiotics belong to the nitrofuran group. Furagin and Furamag contain the same active ingredient - furazidin. Accordingly, they are similar in their pharmacological action. In view of this, we can easily replace Furagin for urolithiasis with the drug Furamag for urolithiasis and other urological infectious pathologies.

They destroy and kill bacteria located in the urinary tract without destroying their capsule, which does not lead to increased intoxication of the patient’s body, and the therapeutic and visible effect in the form of improvement in general condition occurs immediately.

Furadonin, in turn, contains the active substance nitrofurantoin, but also belongs to the group of nitrofurans. This drug affects protein synthesis in bacteria, causing a bactericidal and bacteriostatic effect. Furadonin in urolithiasis is widespread, so it rarely causes a number of side effects and body reactions, and is highly effective.

Also, diuretics are used as one of the components of therapy, for example furosemide for urolithiasis. Furosemide is a loop diuretic that causes a rapid onset diuretic effect, but of short duration. This therapeutic effect is based on the rapid physiological removal of a small stone (up to 1 cm) through urine flow. Of course, we should not forget about vitamin therapy, especially vitamin B9, or folic acid with urolithiasis.

Based on the above, it should be summarized that all components are important in the treatment of urolithiasis, including antibacterial therapy and the use of herbal remedies, such as phytolysin, or cystone, information about which will be discussed in the next article.

Cyston

Herbal medicine is one of the components of the entire complex treatment, but is of no small importance for achieving the full therapeutic effect. For this purpose, the herbal medicine cystone is used, which, among others, is widely used.

Effects of the drug cyston in urolithiasis

Cyston is a herbal medicine that consists of many components of herbal origin. It contains many extracts of rhizomes and plant stems, which have an antimicrobial and nephrolitholytic effect in the body. The latter is carried out by influencing the formed stone, by dissolving it, as well as providing contributing factors for the removal of stones and salts that contribute to their formation. The antimicrobial effect is carried out due to the influence on pathogenic flora, by reducing the growth and reproduction of pathogenic microorganisms.

Indications for use are urolithiasis, urinary system infections, preventive measures in urological practice, and gout.

Cyston: instructions, reviews for urolithiasis

This drug is usually taken orally. Prescribe two tablets, regardless of food intake, twice a day. The course of treatment is determined by the attending physician, usually it is about four months, and can last up to six months. But if the stones pass earlier, the herbal medicine can be discontinued.

After using this drug cystone, the reviews for urolithiasis in women and men sound very positive. In their reviews of the drug, people describe that after undergoing a course of treatment for urolithiasis, they managed to avoid surgical intervention, the constantly disturbing pain went away, and the process of urination improved. Some have used cystone on their own, reviews, for urolithiasis in men, and they report a positive effect, the effect of which was aimed at preventing relapses.

As a result, we have a fairly effective drug with a good therapeutic effect. But taking into account the characteristics of each organism and specific clinical case, cystone should be included in complex therapy, just like the banal spasmalgon, which will be discussed further. And for appointments you should contact a specialist.

Spasmalgon

Spasmalgon is a widely used drug in all medical fields, including urology. Its use for urolithiasis, especially during an attack of renal colic, is more than justified.

Spazmalgon contains an analgesic of non-narcotic origin, which helps eliminate pain, thereby improving the general condition of the patient. And another of its properties exerts its effect in such a way that, as a result, the smooth muscles of the organ to which the effect is directed relaxes, thereby exhibiting its antispasmodic effect. That is why spasmalgon is widely used for urolithiasis.

Spazmalgon is the leading drug and, as a rule, for urolithiasis is used in the form of a solution, but it is also possible to use a tablet form.

Dosage regimens are established in each case. If renal colic is present, the frequency of administration can be up to five times per day.

Of course, there are also other antispasmodics used in urology for urolithiasis, as well as painkillers. But you shouldn’t place all your hopes only on this type of medication, since all therapy should be combined. Likewise, the prevention of urolithiasis, which we will discuss in more detail in the next article, requires an integrated approach.

Prevention

Any prevention of the appearance of any diseases or their relapses is important. Because best medicine- This is preventive. But it is worth noting that more than half the success of any prevention depends on self-control and compliance with all recommendations by the patient himself.

Prevention is divided into primary and secondary.

Primary prevention for urolithiasis

Primary prevention involves measures aimed at preventing the occurrence of this disease if a person has abnormalities from the norm and has a predisposition to its development. In the case of urolithiasis, the same scheme works, and, based on the reasons leading to its development, primary prevention will be developed.

First of all, measures to prevent urolithiasis include regular medical examination. This is what makes it possible to identify deviations in the state of the body, for example, a chronic disease of the urinary system in a sluggish form that is not noticeable to the patient. This examination includes clinical examinations of blood, urine, and ultrasound examination of the urinary system. And if any pathology is detected, which in the future can lead to stone formation, carry out treatment. Only in this case, perhaps, does primary prevention of urolithiasis include medications for the purpose of sanitizing foci of infection.

Diet is also an integral part of preventing diseases such as urolithiasis (prevention). It is necessary to strictly adhere to the diet; meals should be fractional. You should definitely refrain from eating fatty, fried, salty, smoked, spicy foods, and try not to eat canned food. Do not load the body with only protein foods, including plant proteins, but introduce a rational, balanced diet, rich in proteins, fats, carbohydrates, and other things.

It is necessary to adhere to the drinking regime. You need to drink as much purified water as possible, and not abuse carbonated drinks, alcohol, and even mineral waters rich in various elements and minerals.

Introduce time for physical activity into your daily routine, especially for those people whose daily routine involves sedentary work.

Secondary prevention of urolithiasis

This type of prevention is aimed at preventing relapses in case of cure, or at maintaining the condition of the body after surgery in order to prevent further development of the disease and aggravation of the situation.

Secondary prevention of urolithiasis, like primary prevention, includes all the same points. Depending on the type of stones that have already formed, further preventive therapy can be adjusted. Thus, stones formed from oxalate salts require the exclusion of such foods as sorrel, vitamin C, chocolate, coffee, baked goods, spinach.

If urates predominate in the urine, it is necessary to exclude fatty foods: broths, fatty fish, sauces, vegetable proteins.

Phosphate stones require sharply limiting foods containing large amounts of calcium, meat, and spicy dishes.

But there are nuances. For example, in this case, preventive examinations are carried out much more often and in accordance with the recommendations of the attending physician. There is a specific examination program for the prevention of urolithiasis.

In this section, in the pathology of urolithiasis, prevention and treatment go hand in hand. The main direction is periodic sanitation of the urinary system with medication, as well as the use of long-term medications to maintain balance in metabolic processes. Such drugs for the prevention of urolithiasis are widespread. An example is allopurinol, which reduces uric acid levels in the urine.

Herbal medicines are considered popular and effective. They contain only herbs that can have a good therapeutic effect without harm to the general condition of the body. Thus, the prevention of urolithiasis in women does not include medication in this case, the same as for men. This version of preventive measures includes drugs such as phytolysin, cystone and their other analogues.

In order to avoid relapses after successful treatment, it is advisable to prevent urolithiasis in humans in the form of sanatorium and resort treatment. This method will be effective after surgery, and during the period of stone formation. The type of resort is selected by the attending physician, since different types of stones require exposure to different climates and waters. Contraindications to this type of prevention are inflammatory diseases of the urinary system and acute conditions.

conclusions

It should be noted that everyone has approximately the same risk of developing urolithiasis. The only exception is gender. Thus, prevention of urolithiasis in men, especially those with a complicated history, should be carried out more often. But in general, in order to avoid this disease, you should adhere to a daily routine with physical activity, a balanced diet, and a drinking regimen. And also regularly undergo preventive examinations, especially in more detail, in case of suspected pathology of the urinary system. By following all the above recommendations, you can prevent undesirable consequences, or identify and stop the disease in the early stages of the development of the process. It is possible that even for preventive purposes, specialists prescribe antibacterial drugs in order to sanitize the chronic inflammatory process and prevent further progression of the pathology. We will describe below exactly which antibiotics are prescribed and which ones have their own characteristics.

Antibiotics

Antibiotics for urolithiasis in women as well as men are used in the event of the development of calculous pyelonephritis, acute or chronic, against the background of this disease.

In urology, a number of antibacterial drugs are used that act directly in the urinary tract. The main groups of antibiotics and representatives of these groups are:

• Fluoroquinolones and their action are based on blocking the genetic information of microorganisms and, as a result, have a bactericidal effect. These include ofloxacin, levofloxacin, gatifloxacin, ciprofloxacin and others.
• Nitrofurans have an effect on bacterial proteins and cause the growth of bacteria to stop and their death. Such drugs are furamag, furagin, furadonin.
• Further, in case of resistance of microorganisms, a group of cephalosporins is used, which act on the cell wall of bacteria. The following drugs are used here: ceftriaxone, cefuroxime, cefepime, and so on.
• Also, if there is no effect from previous drugs, carbapenems (meropenem) are used.

When asked what antibiotics are used for urolithiasis in men and women, you should consult a specialist. But if antibiotic therapy is not needed, for treatment during the recovery period you can turn to traditional medicine, the methods of which will be discussed further.

ethnoscience

Urolithiasis (UCD) is a multifactorial disease and therefore requires integrated approach to treatment. In addition to traditional therapy, treatment of urolithiasis with folk remedies in specialized medical institutions is widespread in women and men. As a rule, this type of therapy occurs at home, without the supervision of specialized personnel over the patient’s condition. Due to the fact that any treatment, including folk remedies, must be prescribed by a doctor. Before starting therapy, you should undergo a thorough medical examination, without self-diagnosing, and consult a doctor.

Even in folk medicine, treatment is multidirectional and depends on the type of stones formed, so the composition of the stones is important in providing adequate therapy.

Treatment for the presence of oxalate stones

Stones consisting of oxalate salts are the most common in this pathology. Their occurrence is facilitated by excessive accumulation of salts formed from oxalic acid and its esters. Such stones are hard and have spinous processes, which puts them at risk of more trauma to the urinary tract in nephrolithiasis. In the case of treatment through traditional medicine of this kind, stones should not exceed 0.5 cm in size. In order to remove the stone from the body and alleviate the patient’s condition, the following is used:

• Drinking regime. It is necessary to consume large amounts of water throughout the day in small portions;
• The use of watermelon-bread diet. You just need to eat large quantities of watermelons and black bread. But the diet has disadvantages, as excessive consumption of watermelon can aggravate the condition;
• The next treatment option is to use an infusion of grape branches. To do this, chop the grape branches and pour only boiling water. Then the resulting decoction should be left to steep for about an hour. Should be taken orally three times a day, ¼ cup;
• We will also use the most effective recipe. It contains equal parts of bearberry, knotweed, corn silk, and hernia. Then, the resulting mixture in a volume of 1 tablespoon is poured with one glass of boiling water, as a result of which it is infused. Afterwards, take 1/3 cup orally 3 times a day. This composition is very close in composition to herbal medicines that are used for urolithiasis;

Traditional medicine in the fight against phosphate stones

Stones formed from phosphate salts have a soft consistency, easily crumble and dissolve, and their surface is smooth. Based on this, we can conclude that for treatment it is necessary to increase the level of urine acidity. For this purpose, grape juice and various infusions from branches and seeds are used. The use of lemon is also practiced in the fight against illness. Combinations of honey, parsley and lemon are possible; in this case, urolithiasis stops its progression and improves the prognosis.

It is necessary to make a decoction for urolithiasis from a collection of the following plants: for this, take corn silk and birch leaves in equal parts and proportions, along with steelweed and burdock root. Next, grind and pour boiling water over it, let it brew. The decoction is prepared in a 1:1 ratio, equal parts water and herbs. Take one tablespoon after meals.

Also, a collection of herbs, which includes rose hips for urolithiasis, increases the acidity of urine, and it is possible to take sour fruits, barberry, St. John's wort and other similar plants. A decoction is made from these components. Rosehip can also be used separately. To do this, you need to pour the root of this plant with one liter of just boiled water and heat it on the stove for about fifteen minutes. Afterwards, the decoction is diluted with the same amount of cooler water and taken half a glass every eight hours.

You can also take sour juices for urolithiasis. At the same time, it is important to observe moderation.

Urolithiasis: traditional treatment of urate stones

This type of stone is formed from potassium and sodium salts, as well as uric acid. Here we should focus on what is used traditional treatment urolithiasis in men to a greater extent, since it is men who are more susceptible to the formation of urate stones.

For this purpose, oat grains are used without peeling, washed, and then infused using the same method for 12 hours. The resulting infusion is crushed and taken in the form of porridge for food.

They also use knotweed grass in the amount of one part, and two parts each of currants and strawberries. A decoction is prepared from all this and taken 3 times a day, thirty milliliters each.

General principles of traditional medicine

In addition to specific treatment cases, there are treatment options that are applicable in all cases of stone formation. For example, a urological collection for urolithiasis, which includes dill seeds, eleutherococcus, mint, calendula and bearberry. This composition provides an antimicrobial effect, disinfects, reduces inflammation and increases the overall tone and resistance of the body. This collection contains herbs that are most often used for urolithiasis and are highly effective. And changes in their combinations also play a big role in producing a particular effect.

Also important are the foods consumed for urolithiasis. In addition to special cases of the development of a certain type of stones, there is a single dietary therapy for this disease. You should exclude fatty, fried, spicy, smoked, spicy foods, do not eat canned food, dishes instant cooking. Maintain a drinking regimen of at least two to three liters of ordinary clean water per day. At the same time, systematic consumption of alcohol, carbonated drinks, and mineral waters rich in microelements is strictly prohibited. Diet is the basis of any treatment and any disease, especially such as urolithiasis, which is associated with metabolic disorders. Indeed, in the case of using even the most effective medications and decoctions, if the diet is not followed, the disease will progress or recur. We will describe specifically which products are allowed and which are not in the next article.

Diet

Many people believe that diet plays no role in treatment, but in fact it is completely the opposite. Diet is fundamental in treatment, and just one adjustment can improve the general condition of the body, the prognosis of this disease and avoid relapses.

Nutrition for urolithiasis in men and women, general principles

In order to start eating right, it is enough to adhere to some basic principles. It is also very important to lead a healthy lifestyle and do general strengthening exercises.

But, given that during the disease in question, multiple disturbances in metabolic processes occur, as a result of which stones are formed in the kidneys and other parts, the composition of which differs significantly from each other. Either salts are found in the urine: oxalates, then urates, maybe phosphates and others. So, the type of food a patient eats may vary and will depend on the composition of the stone in the patient.

You should also take into account the general principles by which a patient with urolithiasis, or an already cured patient, should eat. For any kidney pathology, fried foods should be avoided, no matter how tasty they may be. Spicy foods are also strictly prohibited; this includes not only hot spices, but also all possible spices. It is better to remove canned and pickled foods, even if they are homemade, from the diet. Such food should not be consumed even occasionally, “on holidays.”

It is prohibited to eat any kind of food that has been smoked, especially if it is a smoked flavoring used in factories Food Industry(sausages, meat, especially fish). Among other things, if you have urolithiasis, it is strictly forbidden to drink carbonated drinks and coffee. As for alcohol, this is a separate topic that requires close attention. Alcohol, when consumed, carries a very large burden on the body, the products of its metabolism have a particularly detrimental effect on the liver and kidneys. This is what you should not eat if you have urolithiasis.

Mineral waters are very important, which in turn are selected in composition depending on the type of stones formed. On the manufacturers' labels you can read the composition, which should include: hydrocarbonas (HCO3-), chloridis (Cl-), sulfatis (SO4 2-), natrium (Na+), kalium (K+), calcium (Ca 2+), magnium ( Mg 2+), and other components.

What can be eaten with urolithiasis of the kidneys includes almost all foods, but not in all types of processing. If ICD is diagnosed, steam processing of most food products not included in the list of prohibited foods is allowed, and it is also possible to prepare boiled and stewed dishes. Strengthen your drinking regime with purified water. Food should not be too hot or cold, and also contain easily digestible ingredients. The meal plan should be fractional. That is, frequent meals in small portions, enough to start energy metabolism.

Diet for urolithiasis (women and men)

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In view of the fact that during the formation of kidney stones there may be a predominance of certain salts, which may consist of stones in the urinary system, nutrition must be selected on an individual basis. Such a diet will be prescribed separately by a specialist, and depends on the type of stones formed and their composition. Thanks to this, through diet therapy it is possible to influence the conditions that will contribute to the destruction of the stone in each specific case.

It is important to understand that self-medication in such cases is inappropriate, as this can result in even more complex and serious consequences, and further surgical intervention.

Diet for urolithiasis (in men) – urates

According to statistics, men are more susceptible to the formation of urate stones. Of course, the diet we will discuss is also suitable for women.

Urate stones are formed as a result of an excess of uric acid. The purpose of nutrition is to prevent alkalinization of urine and reduce the rate of stone growth. So, what you need to follow in order to get a noticeable therapeutic effect:

• Meat products and most fish dishes are removed from the diet. Food must undergo thorough steam treatment and be served in the form of boiled dishes; processing of products in an oven at a temperature not exceeding one hundred and eighty degrees, as well as in a stewed version, are acceptable.
• It is important to remember about those food products, the list of which includes meat from young animals, especially fatty varieties, sausages, sausages, sausages, and factory-produced semi-finished products.
• As for vegetables, exclude all types of legumes, spinach, and most importantly sorrel, cauliflower, and mushrooms. Do not take cranberry juice or cocoa.
• You should include low-fat varieties of hard cheeses in your diet, possibly homemade ones. This also includes cottage cheese with a low percentage of fat, coarse cereals due to their high content of B vitamins (riboflavin, thiamine, pyridoxine, nicotinic acid, cyanocobalamin, niacin equivalent or vitamin PP and many others). You can eat soups prepared with vegetable broth, adding herbs (parsley, dill).
• You should limit your intake of pasta, baked goods, jam, berries, honey, and dried fruits.
• Potatoes, bell peppers, tomatoes, beets are allowed for use.

By following these simple rules in conjunction with the prescribed medications, you can feel a positive result within a few weeks.

Diet therapy for oxalate stones

These are dense formations, which mostly contain calcium and ammonium oxalate. Accordingly, in the event of the formation of this type of kidney stones, it is first of all important to exclude products containing oxalic acid. Therefore, a diet for urolithiasis is recommended, for which it will not be difficult to create a menu:

The patient's diet should include dairy and fermented milk products, whole cereal grains, as well as various types of cereals. Vegetable base diets include all types of legumes, eggplant, pumpkin, cauliflower, peas, and potatoes. You can add pears, apples, watermelons, bananas, apricots, grapes and dried fruits to your diet.

Limit foods containing vitamin C (acidum ascorbinicum), tomatoes, parsley, dill and other herbs, berries (sour), strong tea for urolithiasis, chicken and beef.

It is forbidden to consume sorrel, lettuce, figs, spinach, and chocolate in your diet. In the acute stage, patients with this type of stones are excluded from dairy dishes.

All of the above products are also balanced in their content of vitamins (Thiaminum, Riboflavinum, Pyridoxinum, acidum nicotinicum) and many others necessary for normal functioning.

Diet for urolithiasis of the kidneys (women and men) – phosphates

In this case, the concentration of alkalis in the urine increases, so diet therapy is aimed at its oxidation. This, in turn, allows you to restore the acid-base balance. To do this, you will need to change your diet and include the following products:

• Little by little you can eat flour products, including baked goods.
• As a source of many useful substances necessary for the body, and especially proteins, you should not give up meat and fish.
• It is also necessary to eat vegetables and greens. Fruits that can be included in the diet include apples and pears.
• Porridge included in the diet should have a more mucous and boiled consistency in order to avoid difficulties in digestion and breakdown.
• Soups without rich broths are practically a panacea for any type of body disease.
• But it is worth sharply limiting the use of butter in food, especially fatty oil; sunflower, as well as olive and others also belong here and can be used only in small quantities for the purpose of preparing dishes.
• Lovers of coffee, cocoa and chocolate should avoid them.

All diets were developed and proposed for therapeutic practice by nutritionist Pevzner. The diet table for urolithiasis has serial number 14, and it allows you to eat almost everything. But later, the diets described above were developed in accordance with the origin of the stones, which give a positive therapeutic effect.

Based on the proposed diet tables, we can offer an approximate menu for urolithiasis in men and women equally.

Breakfast can consist of any type of porridge, preferably green tea, which can be replaced with milk. After a while, eat an apple.

For a second breakfast, a small amount of cottage cheese or yogurt is suitable; you can wash it down with rosehip decoction.

Lunch includes a more extensive menu of any first course, such as soup. For the second meal, you can offer the patient steamed cutlets, meatballs and vegetables. Suitable drinks include compote or tea to suit the patient's taste.

Dinner, both the first and second, should be light and based on fermented milk products (kefir, cottage cheese), or light pastries with tea.

There are many options for creating a menu. The main thing is to follow the basic principles of cooking methods, especially the drinking regime. We will tell you further about how to observe it, and what water should be consumed and what not.

Water for urolithiasis

Urolithiasis requires close attention to your health. This disease requires not only drug treatment, surgery and diet. A mandatory point in treatment is the drinking regime. Let's look at what it includes further.

Drinking regime, what does it include

The concept of drinking regime includes taking fluid every day in the amount required by the body. For this purpose, the patient should take about two liters of liquid per day, but no less. This volume includes drinks allowed by the diet (tea, cocoa), juices, mineral waters. This is necessary in order to increase the daily excretion of urine, and, accordingly, small stones can be excreted in the urine, and this amount of liquid also helps to reduce the accumulation of salts in the urine. This reduces the precipitation of salts and, subsequently, the formation of stones.

Any water must be drunk at room temperature; drinking cold or hot water is excluded. You should also not take water from the central water supply.

In addition to regular boiled or filtered water, the use of bottled mineral water is allowed. But it is necessary to approach the choice of mineral water of spring origin as responsibly as when choosing a specialized diet, since not all water can be useful for this disease.

What water to drink if you have urolithiasis

Only after the patient has been diagnosed with ICD and has reliably determined the type of stones formed can one begin to choose one of the varieties of mineral waters. It is worth remembering and knowing that not every carbonated clear water in a plastic or glass bottle is mineral, much less healthy and medicinal.

At the same time, if we talk about beneficial properties, then the mineral water in its composition should contain a number of chemical elements, as well as compounds necessary for the body, especially in case of a particular disease. But, due to the fact that the shelves of pharmacy chains are replete with various brands of manufacturers and numbering of mineral waters, it becomes difficult to choose the right drink. Let's consider some of the properties that water from a spring source must have in order to have a beneficial effect on the course of urolithiasis. Mineral water should cause a slight diuretic effect, have antiseptic properties, reduce the symptoms of general intoxication in the body, and have an appropriate composition of minerals and trace elements that have a beneficial effect and promote the dissolution of stones.

Such waters that are not only allowed, but also indicated for use in urolithiasis include:

• "Essentuki 4" for urolithiasis containing carbon dioxide;
• mineral water “Naftusya”, which contains bicarbonate, a sufficient amount of magnesium and calcium;
• No. 20 and No. 17 “Essentuki” are also used for urolithiasis;
• Berezovskaya water, one of the components of which is iron;
• And other mineral waters are successfully used for urolithiasis of the kidneys. It should be noted that the content of minerals in them is slightly higher than in the previous ones (Narzan, Borjomi).

The above brands can be used for this pathology. It is better to check with your urologist about which mineral water for urolithiasis, names, list, is indicated in a particular case. As a result, if a patient is advised to drink alkaline mineral water for urolithiasis, then the choice of the type and brand of mineral water remains up to the patient. But only from the list suggested by the doctor or in our article.

How does mineral water affect the body during urolithiasis?

This kind of drink affects the body in such a way that it promotes the rapid dissolution of stones formed in the kidneys, due to a decrease in the sedimentation of salts. Since mineral waters differ in composition, depending on the presence of one or another component, water has a different effect on the course of the disease and on the body.

Water can help break down stones of phosphate origin, as well as oxalates, if it contains iron, tungsten and silicon. Therefore, the choice of mineral water should be approached with all responsibility, taking into account the composition of the liquid. But it is best to seek advice from a therapist or urologist.

Alkaline mineral water is indicated for gout and urolithiasis due to the decrease in the concentration of uric acid due to regular intake of sufficient fluid.

If oxalate stones, which predominantly contain calcium, are formed and identified by a doctor, liquid containing calcium is contraindicated. Therefore, you should carefully read the composition before purchasing mineral water.

Water with low mineralization can have a bactericidal effect and reduce the inflammatory process.

Contraindications to taking mineral waters

Mineral waters, like any medicine, are a medicine and have a number of indications and, importantly, contraindications for their use. Contraindications to the use of such waters include:

• Presence of acute or chronic renal failure;
• The patient has a chronic bacterial long-term process in the kidneys;
• In case of any complications of kidney disease, including urolithiasis;
• Final diagnosis diabetes mellitus at the patient.

How much water to drink if you have urolithiasis

In each specific case, only a doctor can accurately indicate the number and frequency of medicinal mineral water intakes, as well as the duration of its treatment. However, if the patient is not given any special recommendations, then to prevent relapses, any of the mineral waters should be taken up to half a liter per day. In the case of direct treatment of urolithiasis with the presence of stones, take one glass of water every two hours. The duration of such therapy is one month, in some cases – two. Also, do not forget that mineral water must be consumed heated, since the liquid is better absorbed when warm. In addition, it is recommended to first degas the liquid by opening the container.

It is not recommended to independently extend the duration of drinking mineral water due to the increased risk of disrupting metabolic processes in the body and leaching of useful substances.

Taking into account the above, we can summarize that alkaline water for urolithiasis is one of the methods that is part of a complex treatment and requires strict adherence to all instructions for its use and duration of treatment.

But, before you begin to maintain a drinking regime using mineralized spring waters, you should consult your doctor and clarify further tactics for its treatment. Since with a planned surgical intervention in the near future, there are a number of features in which this product can be excluded. We will talk about what surgical treatment may be indicated for urolithiasis in the next article.

Surgical treatment

In the treatment of urolithiasis, various methods are used, including surgery. This treatment option is currently used more often than others as a result of late presentation of patients and lack of prevention.

Surgery

This method of treatment is carried out by direct access to the location of the calculus by making a cut with sharp instruments and entering the retroperitoneal space. Such an operation is indicated in the event of a number of complications of urolithiasis, namely acute disruption of the outflow of urine due to blockage of the urinary tract by a stone, or in the presence of bleeding of renal origin. These indications are direct to surgery, or otherwise urgent. More “indirect” or relative ones include frequent attacks of renal colic that cannot be controlled with medication, chronic calculous pyelonephritis with increasing dilatation of the renal pelvis.

This type of treatment has its own adverse consequences. Urolithiasis may recur after surgery, resulting in obstacles to repeated surgery due to the high risk of mortality.

Urolithiasis laser surgery

There is a progressive modern method of treating urolithiasis - this is the method of external shock wave lithotripsy, otherwise called the “laser” method. This technology allows without incisions and penetrations into the body through the influence of a powerful concentrated beam of waves under the control of radiography or ultrasonic method to specifically destroy large stones of the urinary system, turning them into stones of a much smaller size, and in some cases, even into sand. Consequently, the crushed calculus will be able to pass naturally with a stream of urine.

At the same time, there is a good effect in treating the disease urolithiasis, the cost of the operation, which will not be cheap, since not every medical center or clinic can afford such equipment.

Other methods of surgical treatment

At this time, the most optimal method of surgical treatment in terms of its effectiveness and cost is endoscopic surgery, which is also widely used in urology. Cystoscopy is a representative of this method. In this case, after preliminary use of antispasmodics, inject into the urethra special device– cystoscope. Then, going up to the location of the stone, the stone is crushed with a cystoscope and removed.

And also nephroscopy is an endoscopic method, access in which small skin incisions are made and the stone is removed using a nephroscope, having previously crushed it. This kind of surgery for urolithiasis in men and women is performed in the same way.

Urolithiasis in pregnant women, the operation performed in these situations is pyelolithotomy or ureterolithotomy. But only according to strict indications. Of course, in the case of a combination of this pathology and pregnancy, it is better to carry out prevention and conservative therapy and not allow the development of an acute condition. And one of the helpers in this is physical therapy. We will talk about it in more detail in the next article.

Exercise therapy

Urolithiasis requires an integrated approach to treatment and prevention. Not only should drug or surgical treatment be used, but also diet therapy and physical therapy. ITS effects cannot be underestimated. If the stones are small in size and have a smooth surface, if this is established as a result of a thorough diagnosis, with the help of therapeutic exercises it is possible to remove the stone naturally with a stream of urine.

What is physical therapy for urolithiasis?

Like any method of treatment, physical therapy also has its own indications and contraindications.

The indication is the presence of a stone in the urinary tract up to one millimeter with a smooth surface.

Contraindications include an attack of renal colic, renal failure, pathology of the cardiovascular system, location of the stone in the renal pelvis.

The purpose of such physical education is to normalize and improve the outflow of urine, improve blood circulation in the pelvic area, reduce pain symptoms and reduce edema, provide conditions for expelling stones from the body, and stabilize the clinical situation.

There are sets of exercises aimed at strengthening the muscles of the back and abdomen. All classes are held at a slow pace and do not involve intense stress and tension on muscle tissue during and after exercise. There are also exercises for the leg muscles in the physical therapy program. Every time you start a series of exercises, you should first start with measured walking. This method of starting the complex helps to increase blood circulation and increase respiratory movements, which tones the body as a whole.

Gymnastics for urolithiasis

There are a number of exercises that must be performed slowly and gradually, while others are aimed at a sharp change in body position in order to abruptly move the internal organs, promoting the displacement of the stone. Before starting exercises, it is recommended to take an antispasmodic drug.

Start the exercise with simple walking in place at an average pace.

After this, slowly move on to the next exercise. Hands should be along the body. You need to raise your arms up and at the same time move one leg to the side as sharply as possible. Then another.

Method 4 of exercise therapy for urolithiasis includes sharp turns of the body with arms spread to the sides.

Then you need to move on to bending the whole body as close as possible to one knee, straighten up, and repeat the bend to the other knee.

As usual, any exercise ends by stretching your arms and torso upward while inhaling, and then bending down and exhaling.

And finally, while kneeling, raise your pelvis up, while your knees should be aligned. Breathing is smooth.

As a result, the effectiveness of exercise therapy for urolithiasis is assessed through an objective examination and some studies, which are confirmed by the release of stones from the urinary tract, or by improving the general condition of the patient.

Regardless of gender, physical exercises for urolithiasis in women and men are carried out in the same way.

Physiotherapy for urolithiasis

In addition to exercise therapy, physiotherapy is carried out during the period of remission of the disease and to prevent relapses. For this purpose, a wide variety of physiotherapy procedures for urolithiasis are used: magnetic therapy, reflexology, mud therapy, massage, and massage through the shower - hydrotherapy, galvanization, ultrasound, the use of ozokerite. All these procedures improve blood circulation throughout the body, and electrical impulses under the influence of galvanization improve metabolic processes through a number of transformations. As a result, the risk of developing pathologies such as urolithiasis is reduced.

But the use of all treatment methods is completely incompatible with alcohol consumption. We will talk about its effect on the body in this situation in the next article.

Alcohol for urolithiasis

The pathology of urolithiasis develops as a result of multiple factors, the main one of which is a violation of metabolic processes in the body, which arise as a result of a violation of the diet. Alcohol intake in this case can also be attributed to a dietary disorder. Let's consider the effect of alcohol on the kidneys in principle and in case of urolithiasis and find the answer to the question of whether it is possible to drink if you have urolithiasis.

Alcohol and its effect on the kidneys

You can often find people drinking alcoholic beverages. And we are not just talking about the abuse of this product. Often banquets, holidays, and meetings are not complete without these drinks. But even drinking alcohol in small quantities can lead to negative consequences.

When alcohol enters the body, it passes through many departments and various chemical transformations occur in them. One of the most toxic substances that is formed from ethanol in the human body is acetaldehyde. This chemical compound has a destructive effect not only on the brain and liver, but also on the kidneys, since they remove all toxins from the body. This compound has a destructive effect on kidney tissue.

Also, one of the common effects after drinking alcoholic beverages is water imbalance. There is a misconception that you can drink beer if you have urolithiasis, since it is supposedly a diuretic and helps remove stones from the urinary system. This is absolutely not true. Any alcoholic drink, regardless of whether it is beer, vodka, wine, low-alcohol drinks, etc., has the same effect on the body as a whole and on the kidneys. Once in the body, alcohol retains water in it, as a result we have severe overhydration, swelling not only external, which is visible to the eye, but also internal, including swelling of the kidney parenchyma and other tissues at the cellular level. Then, when the elimination of ethanol products from the body begins, they pull with them most of the liquid, thereby causing dehydration of the body, bringing it back into a state of stress, which is manifested by severe thirst.

Is it possible to drink alcohol if you have urolithiasis?

Let's look at the interaction between alcohol and urolithiasis. With urolithiasis, the kidneys are already compromised, their function suffers due to the presence of stones in them or complications caused by the disease. And given that alcohol reduces the ability of the body and kidneys to remove uric acid from the body, this aggravates the course of the disease.

Also, it is worth noting that after fluid retention in the body after drinking alcohol, its abundant elimination begins with the help of those suffering from urolithiasis by the kidneys. As a result, an increased volume of urine can dislodge a stone located in the urinary system and cause an attack of renal colic, and, consequently, a worsening of the condition, and possibly lead to surgery.

It is also necessary to take into account that alcoholic drinks disrupt metabolic processes in the body, leading to their disturbances. In view of this, there should not even be a question about what kind of alcohol is possible for urolithiasis.

Under conditions of intoxication due to alcohol, a kidney suffering from urolithiasis, which is already under increased load, may experience even greater difficulties in excreting urine and excreting toxins - the breakdown products of ethanol. As a result, the outflow of urine slows down, and alcohol breakdown products are retained in the body, which, in turn, further increases intoxication and stress on the kidneys. Further, along with toxins, fluid is retained, and swelling of all organs and tissues of renal origin develops.

So the question of whether alcohol can be used for urolithiasis in men and women is very controversial. On the one hand, alcohol is a diuretic, but, on the other hand, this effect results in a triple load for the kidneys (swelling, increased diuresis, intoxication). Therefore, you should weigh the pros and cons.

Beer for urolithiasis in women and men

The question is often asked about whether it is possible to drink beer if you have urolithiasis. In view of the above, it becomes clear that drinking beer with this pathology is absolutely forbidden.

The information that beer dissolves stones is just a myth. And the question is it possible to drink beer for urolithiasis in men? Urologists are asked quite often. This drink does not contain any substances that could in any way affect this process. Just like other drinks containing ethanol, beer has a toxic effect on kidney tissue, first causing swelling and overhydration, and then dehydration and stress for the kidney parenchyma. Plus, the “beer” that is sold on store shelves does not have a classic composition, like in home breweries, and consists of many chemicals that also have a toxic effect on the kidney parenchyma.

Therefore, what kind of alcohol can be drunk with urolithiasis is up to the patient to decide, since all drinks of this kind cause a lot of complications, sooner or later. And whether or not to drink alcohol with this disease is a personal matter for everyone.

We will describe the complications of urolithiasis below.

Complications of urolithiasis

Urolithiasis has a number of complications that can arise if the pathology is not treated or the patient seeks medical help late.

Complications of urolithiasis of the kidneys

The following complications may occur with urolithiasis:

• The development of a urinary tract infection due to blockage and disruption of the outflow of urine. As a result, pyelonephritis, urethritis or cystitis develops. They can be combined.
• Promotion blood pressure, which is called nephrogenic hypertension.
• Sclerotic changes in the kidney parenchyma and its replacement with connective tissue due to prolonged compression of the kidney tissue.
• Complications in the form of purulent foci in the structure of the kidney (kidney abscess, kidney carbuncle, pyonephrosis, etc.).
• Blockage of the kidney and further accumulation of fluid in it, which compresses the kidney tissue, as a result of which it becomes thinner and hydronephrosis develops.

Urolithiasis risk factors for complications

All of the above complications develop when risk factors for urolithiasis appear. These include the presence of large stones, which can obstruct the urinary tract and cause sclerotic changes and hydronephrosis; the presence of a focus of chronic infection without appropriate treatment can also cause the development of pyelonephritis and other infectious complications; also, prolonged self-medication or failure to follow the doctor’s recommendations and prescriptions can lead to serious complications. Poor diet and alcohol abuse can also be considered factors predisposing to the development of serious complications of urolithiasis. Therefore, if this pathology is present, you should not start the process and contact a specialist.

Urolithiasis (urolithiasis) is a disease that occurs as a result of a metabolic disorder in which an insoluble sediment in the form of sand (up to 1 mm in diameter) or stones (from 1 mm to 25 mm or more) is formed in the urine. Stones settle in the urinary tract, which disrupts the normal flow of urine and causes renal colic and inflammation.

According to medical statistics, urolithiasis is the second most common among all urological diseases, and the third among urological diseases leading to death. Urolithiasis affects people of any age, including children, but the main age group is people aged 25 to 45 years. The disease is more common in men than women, but women are more likely to be diagnosed with severe forms of the disease. It is also known that stones are more often formed in the right kidney than in the left, and in approximately 20% of cases both kidneys are involved in the pathological process.

Causes of urolithiasis

Many factors play a role in the occurrence of urolithiasis, but the mechanism of stone formation and its causes are not fully understood. It is known that the leading role is given to the structural features of the renal tubular system, when the anatomical structure of the kidney itself contributes to the occurrence of congestion. At the same time, the formation of stones also requires the influence of external factors, mainly diet, as well as drinking conditions. Also in the development of urolithiasis, diseases of the genitourinary system, endocrine pathologies (especially diseases of the parathyroid glands, which directly affect metabolic processes involving calcium), and long-term use of certain medications (sulfonamides, tetracyclines, glucocorticoids, aspirin, etc.) play a role.

Types of urolithiasis

Various metabolic disorders cause the formation of stones that differ in their chemical composition. The chemical composition of stones is important, since medical tactics in the treatment of urolithiasis, as well as diet correction to prevent relapses, depend on this.

The following stones form in the urinary tract:

• Stones based on calcium compounds (oxalates, phosphates, carbonates);
• Stones based on uric acid salts (urates);
• Stones formed by magnesium salts;
• Protein stones (cystine, xanthine, cholesterol).

The main share is made up of calcium compounds (about 2/3 of all stones), protein stones are the least common. Urates are the only group that can be dissolved. These stones are more often detected in older people. Stones consisting of magnesium salts are most often accompanied by inflammation.

Stones due to urolithiasis can form in any part of the urinary tract. Depending on where they are located, the following forms of the disease are distinguished:

• Nephrolithiasis – in the kidneys;
• Ureterolithiasis – in the ureters;
• Cystolithiasis – in the bladder.

Urolithiasis is initially asymptomatic. The first signs of urolithiasis are discovered either by chance, during an examination, or with sudden onset of renal colic. Renal colic is a severe pain attack, often the main symptom of urolithiasis, and sometimes the only one, resulting from spasm of the urinary duct, or its obstruction by a stone.

The attack begins acutely, with sharp pain, the localization of which depends on the location of the stone. The pain is intense and can radiate to the groin, lower abdomen, and lower back. Urination becomes painful and frequent, and blood is found in the urine (hematuria). Nausea and sometimes vomiting appear. The patient rushes about in search of a position that would bring relief, but does not find such a position. An attack of renal colic can occur with subsidence and exacerbation of pain, and end either in the removal of the stone, or in the subsidence of the colic, or in the development of a complication.

It should be noted that the severity of signs of urolithiasis is not always related to the size of the stones. Sometimes small stones, not exceeding 2 mm, can cause severe colic, while there are cases of severe kidney damage, when multiple stones fused into coral-shaped formations do not lead to colic, but are discovered by chance or when complications of urolithiasis begin.

Diagnosis of urolithiasis

Diagnosis of urolithiasis is based on the characteristic clinical picture of renal colic and ultrasound data. Computed tomography and magnetic resonance urography are also informative. A detailed urine analysis is carried out using functional tests (according to Zimnitsky, Nechiporenko, etc.). Bacteriological examination of urine is mandatory. Radiography has now lost its leading place in the diagnosis of urolithiasis, but is still used as an additional method.

Treatment of urolithiasis

An attack of renal colic is relieved with the help of antispasmodic and analgesic drugs. The main treatment of urolithiasis is carried out in the absence of acute manifestations.

Urolithiasis is considered a surgical disease, but urolithiasis caused by the formation of urates can be treated medically by taking drugs that dissolve these stones. Other types of stones require mechanical removal.

Treatment of urolithiasis is carried out using two main methods: lithotripsy and surgery. External shock wave lithotripsy is an effective method for treating urolithiasis, in which stones in the urinary ducts are broken up using a shock wave and then excreted in the urine. The method has proven itself to be excellent; thanks to it, the indications for surgical intervention in the treatment of urolithiasis have significantly narrowed.

The operations used to treat urolithiasis are divided into open and endoscopic, as well as organ-preserving and radical. A radical operation is to remove the kidney if it has lost its function. The preferred method in choosing surgical treatment for urolithiasis is endoscopic techniques, which allow stone removal without making an incision in the abdominal cavity.

Prevention of urolithiasis

Prevention of urolithiasis is a necessary condition for complete recovery, since without it relapses are inevitable. The basis for the prevention of urolithiasis is adherence to a diet that normalizes metabolism and the biochemical composition of urine, as well as compliance with the drinking regime. The diet for urolithiasis is developed depending on the chemical composition of the stones. So, with oxalates, dairy products and chocolate are excluded from the diet, and with urate stones, the consumption of meat is limited. An extremely important condition is to take enough water - 1.5 - 2 liters per day.

Video from YouTube on the topic of the article:

Urolithiasis (UCD) is a term that is familiar to a huge number of people. This disease is characterized by the appearance of various types of stones in the organs of the urinary system. Most often, the disease occurs in people of working age - from 22 to 55 years. In the absence of timely treatment, 6% of patients suffering from it risk receiving 2nd degree disability.

Scientists believe that the presence of stones in the genitourinary system is a manifestation of an imbalance in the entire body. It is impossible to say that only one factor led to the appearance of this disease.

Factors that provoke the development of kidney urolithiasis in women and men can be very diverse. There are reasons that contribute to the appearance of stones in the organs of the genitourinary system, and mechanisms that directly result in the appearance of stones.

The reasons contributing to the development of urolithiasis include:

1) congenital abnormalities of the kidney structure. In most cases, stones appear in the kidneys and from there descend into the ureters, bladder, and urethra. Congenital anatomical narrowing of these organs contributes to the appearance of stones;

2) metabolic disorders in the body. Congenital or acquired malfunctions in the metabolic system most often lead to the appearance of the disease. These include: oxaluria, galactosuria, uraturia, cystinuria, aminoaciduria. With all these pathologies, excessive amounts of oxalates, urates, galactose, and cysteine ​​are produced, which are deposited in the renal tubules. They are the basis of future kidney stones;

3) genetic predisposition. According to reviews from patients of our medical center in St. Petersburg, whose relatives suffered from urolithiasis and had many stones or single coral stones, this disease can indeed be inherited;

4) exogenous factors, or factors that are outside the body. These include gender, age, geographic location and climate in the region. Thus, middle-aged people with sedentary jobs living in hot climates suffer from impaired urine flow and urolithiasis three times more often than people leading an active lifestyle and living in cool climates. This effect on the body is quite simple to explain - in a hot climate, with a passive body position, urine stagnates in the genitourinary organs. The high concentration of salts, which arises due to the climate, leads to the formation of disease.

There are also general and local processes within the body that contribute to the development of ICD. Common factors include:

• violation of the metabolism of vitamins A and D;
• long-term immobilization of injured limbs using a plaster cast (more than 3 months);
• excessive amounts of calcium salts in the body;
• the presence of a bacterial infection in the body, including bacterial pyelonephritis;
• long-term use of certain medications (antacids for chronic gastritis and ulcers, tetracyclines for bacterial diseases, sulfonamides for autoimmune diseases, ascorbic acid for vitamin deficiencies, glucocorticoids after transplantations, for multiple sclerosis and a number of other diseases), can also cause the development of urolithiasis.

Local factors include various diseases and conditions of the genitourinary system:

• anatomical structural disorders;
• long-term presence of catheters in the bladder and genitourinary tract;
• insufficient blood supply to the genitourinary organs;
• vesicoureteral reflux;
• spinal cord injuries that impair the flow of urine;
• nephroptosis, or kidney prolapse.

The presence or absence of one or more factors does not mean the appearance of the disease. Only the individual characteristics of the body and a person’s way of life determine the development of this disease.

Formation and types of stones in urolithiasis

The mechanism of formation is quite simple - congenital and acquired diseases lead to an imbalance of various substances in the body. As a result, the amount of minerals that settle in the kidney tubules increases. Constrictions in the renal collecting system, stagnation of urine, and a sedentary lifestyle create ideal conditions for the formation of stones. Small stones manage to pass through the renal hilum into the ureter, where they can become stuck, or move further into the bladder or urethra. Exist different kinds urinary stones. In most cases, stones in the genitourinary organs are polymorphic in structure - they contain various substances. And only the predominance of one of them determines the name of a particular stone:

2) pure oxalate. Most often found in the urinary tract. These include varieties such as wewellite and weddellite. Such stones are formed due to prolonged dehydration of the body - these can be chronic infectious diseases, autoimmune diseases, alcoholism.

3) urate. They are formed due to excessive amounts of uric acid salts in the body. They are often found in people suffering from gout and obesity.

4) phosphate. These are hydroxyapatite, struvite, carbonate apatite. The formation of these stones is associated with substances released by bacteria. That is why it is extremely important to treat bacterial diseases in a timely manner.

5) cystine. Observed in the body when the metabolism of the amino acid cysteine ​​is disturbed. Such stones are quite rare.

6) the most rare occurrence in patients with urolithiasis is the appearance of cholesterol stones. As a rule, they contain a high percentage of oxalates and phosphates. In addition to the variety of morphological structure, each stone has its own color and shape. Thus, oxalates are dark in color with a prickly surface, phosphates are light gray and almost smooth. Urates are yellowish in color with an uneven surface.

The symptoms of the disease depend on the shape, size, location of stones, quantity and mobility. Fixed small stones can form in the kidneys for years without causing any inconvenience to a person. At the same time, one stone with an uneven surface can pass into the ureters, where it will irritate the membranes and nerve receptors, disrupt the outflow of urine, thereby causing severe pain.

There are three main symptoms that characterize the presence of urolithiasis in a person:

• pain;
• hematuria (the appearance of blood in the urine - determined by urine analysis or visually);
• passage of stones or their fragments in the urine.

In most cases, the first two symptoms occur. The third is typical for small stones that can pass through the genitourinary tract. The main symptom of urolithiasis is pain. Its appearance, nature, intensity, localization depend on the location of the stone and its passage through the genitourinary tract. Thus, kidney stones most often cause pain in the lumbar region. If the stone is in the ureter, it can be either in the corresponding part of the back or in the abdomen. When small stones get into the ureter, sometimes its lumen is completely blocked. This causes pain of characteristic intensity and duration, which is called “renal colic”.

Symptoms in patients with extrarenal urolithiasis

Stones that are located in the lower parts of the ureters appear a little differently. In particular, pain will be localized to the side of the midline of the abdomen on the right or left, depending on the affected ureter. The level of pain will depend on the location of the stone - above the navel if the stone is in the upper third of the ureter, on the side of the belly if the stone is in the middle third, below the navel - in the lower third.

Pain in the pubic and suprapubic areas may indicate a stone in the bladder or urinary tract. As a rule, the presence of a stone in the bladder is accompanied by the development of severe pain, the intensity of which intensifies during urination. In this case, drops of blood may be released during or after urination. Scarlet blood before and during urination is a diagnostic indicator of the presence of a stone in the bladder or lower parts of the ureter.

Laboratory criteria

It is not too difficult to identify urolithiasis if a person has at least once had renal colic or a feeling of discomfort in the lumbar region. Objective signs of the disease, together with data from laboratory and instrumental tests, help the doctor make the correct diagnosis and proceed to treatment of the disease.

To diagnose the disease, urine analysis is of great importance. It allows you to determine the nature of the stones and, accordingly, choose the right treatment paths. The pH value of urine is of great importance. If it is 6.0, it means that urate and calcium oxalate stones are likely to form. If the pH reaches 7.1, there is a high probability of formation of phosphate stones with the addition of magnesium. A urine pH of 6.5 will indicate the formation of calcium phosphate stones. When urine pH values ​​between 5.5 and 6.0 appear, uric acid stones may form.

This method is inaccurate and only allows us to guess what the mechanism of stone formation is. It must be used in complex diagnostics of the body. Healthy people and those who have previously been diagnosed with urolithiasis are recommended to take a urine test every three months.

When identifying a disease, it is also important to find the cause of the disease. Therefore, it is necessary to add tests for hormones and microelements to general tests. So, it is necessary to check the activity of parathyroid hormone, thyroid hormones, vitamin D, and catecholamines. It is also necessary to find out the amount of calcium and sodium in the body. An analysis of the amount of uric acid in urine and blood is mandatory.

Instrumental diagnostic methods

Quite relevant methods for diagnosing urolithiasis, which are used in our medical center in St. Petersburg, are ultrasound and excretory urography. Each of these methods has its own advantages and disadvantages. Ultrasound diagnostics allows you to detect stones of any size and any morphological structure. This method can be used by pregnant women; it is also perfect for people with allergies to contrast agents. The disadvantage of the study is the impossibility of examining the entire genitourinary tract, as a result of which a stone may simply not be found. An ultrasound can accurately show the presence or absence of any bladder stones. This procedure is performed only when the bladder is full.

Excretory urography is an x-ray method for detecting stones. Unfortunately, not all stones are visualized radiographically. Thus, oxalate stones will be clearly visible when using this research method, but urate and cysteine ​​stones are not visualized. The essence of excretory urography is the administration of a special contrast agent. In this case, several photographs are taken that allow one to visualize the passage of this substance through the genitourinary tract. Thus, you can see a narrowing in one of the areas of the genitourinary system, which will correspond to the location of the stone.

Excretory radiography has a number of disadvantages and contraindications. So, it could be an allergic reaction to the contrast agent. X-rays are also contraindicated for children and pregnant women due to exposure to radiation to the body. This procedure also cannot be performed during an attack of renal colic and some diseases of the genitourinary system. In the absence of contraindications, excretory urography is best combined with ultrasound examination. This will make it more likely to detect the stone and establish its exact location.

Cystography, an x-ray examination of the bladder, is used to detect stones in the bladder. To do this, a catheter is inserted into the bladder, through which the bladder is filled with contrast. After contrast is administered, a picture is taken that shows the presence or absence of stones. An alternative to these methods is multislice magnetic resonance imaging. This method does not require the administration of contrast, it can be used during an attack of renal colic and it does not irradiate the patient. At the same time, stones of different densities are perfectly visualized in the pictures. The disadvantages of this research method include the high cost of this procedure.

How to treat urolithiasis?

Treatment of urolithiasis has several principles. This:

• elimination of pain syndrome (mainly with renal colic);
• restoration of the normal outflow of urine, which is disrupted due to blockage of the ureter or urethra by a stone;
• stone removal; preventing stagnation of urine in the genitourinary organs and the development of infection.

There are drug treatments for urolithiasis, as well as surgery to remove stones from the urinary tract.

1) Conservative or drug therapy is aimed at eliminating pain, destroying and removing stones. To relieve a painful attack, antispasmodics are best suited.

2) Stone expulsion therapy will be effective in 80% of cases in the presence of stones no more than 6 mm in diameter. Along with drug therapy, therapeutic exercises are actively used to remove the stone. It is aimed at changing the position of the body in space. Therapeutic gymnastics is aimed at placing patients in special positions that facilitate the passage of stones through the urinary system.

3) Drug destruction of stones is effective only in the presence of urate stones. Therapy is aimed at eliminating the cause of stones - removing excess uric acid from the body. Unfortunately, this method is more preventative - it prevents the appearance of new stones rather than destroying existing ones.

4) Most effective method The treatment for urolithiasis is surgery to remove stones. During this procedure, stones of any morphological structure, any size and shape, and any location can be removed.

Postoperative period

An important part of treatment is metaphylaxis in the postoperative period. This is a set of measures that are aimed at removing invisible stones with a diameter of up to 0.5 mm and the remains of crushed stone. Metaphylaxis includes a drinking regimen of at least 3 liters of liquid per day, with control of daily diuresis in a volume of about 2 liters. In this case, special nutrition is prescribed with a decrease in the amount table salt in the diet up to 4.5 g/day. The amount of animal protein should also be limited - 0.8 g per kilogram of the patient's body weight. In the postoperative period, it is recommended to eat easily digestible meat - boiled or steamed beef. Fried and fatty foods should be strictly excluded from the patient’s diet.

Throughout the postoperative period, the patient must actively engage in physical therapy, which will also facilitate the release of residual stone fragments. Each patient is prescribed an individual diet, which is selected depending on the morphological composition of the stone and the presence of changes according to the results of blood tests.

Effective treatment

Treatment of urolithiasis is a guarantee of receiving highly qualified medical care. Modern diagnostic methods at the Union Clinic multidisciplinary medical center in St. Petersburg allow us to conduct all necessary types of research. These include blood tests, urine tests (including the Nechiporenko urine test), as well as instrumental research methods.

To fully diagnose the presence of sludge and the absence of stones in the organs of the genitourinary system, the clinic has installed modern equipment that allows for ultrasound examination of the kidneys, ureters, and bladder. Patients also have access to X-ray examination methods, such as radiography of the abdominal and pelvic organs and excretory urography.

A complete examination of the patient allows highly qualified medical personnel to more accurately assess the patient’s condition and make the correct diagnosis. Moreover, preliminary studies inform the doctor about the size and shape of the stones and the functional state of the kidneys. This determines the scope of medical intervention.

To reduce the trauma that, one way or another, the body is exposed to when removing stones, experts recommend using conservative treatment. However, the approach to each patient is always purely individual. And the scope of intervention depends on the condition of the human body, the size, number and shape of stones, the presence or absence of complications.

Prevention of recurrent stone formation

• Prevention of urolithiasis is the best way to prevent stones from appearing. It consists of fairly simple steps:
• treatment of chronic diseases of the body;
• treatment of diseases of the genitourinary system;
• playing sports 3 times a week;
• eliminating inactivity at work - changing posture and walking during breaks;
• therapeutic exercises in the post-pregnancy period;
• normalization of nutrition - eliminating fatty, excessively salty and sour foods from the diet;
• patients who have had urolithiasis must adhere to the diet prescribed by their doctor;
• determination of calcium and vitamin D levels at least once a year;
• preventive visits to a urologist every six months to a year;
• taking urine and blood tests every three months;
• undergoing an ultrasound examination of the genitourinary organs for people who have had urolithiasis every six months.

Such simple actions help to significantly reduce the risk of stones in the genitourinary system and get rid of all the troubles of this disease.

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Urolithiasis (urolithiasis) is a chronic urological disease, which is characterized by the formation of kidney stones due to metabolic disorders and inflammation in the urinary tract.

It is usually asymptomatic, but may also be accompanied by hepatic colic or lower back pain. Urolithiasis can develop at different ages, but from 20 to 55 years it is more common. Men are more susceptible to urolithiasis; their symptoms of urolithiasis appear several times more often than women. In the latter, complex forms of this disease with the formation of stones inside the kidney are more common.

Stones can appear in any organ of the excretory system. Elderly patients are characterized by the formation of deposits inside the bladder; in younger people, the formation of insoluble structures often occurs in the ureters and kidneys. In the kidney on the right, neoplasms form more often than on the left.

Concretions can be single, but sometimes their number reaches several thousand. Their size varies - from 1-5 mm to huge ones, reaching a weight of 1 kg.

How are stones formed?

There are several theories regarding how kidney stones form and what causes them to appear. According to the latest data, stone formation is a complex process that is influenced by many factors:

1. Genetic predisposition;
2. Bad ecology;
3. Nutritional features;
4. Region of residence - in some areas the water is hard and contains a lot of salts;
5. Hormonal imbalance, especially parathyroid disorders;
6. Metabolic disorders, in particular mineral metabolism;
7. Anatomical features of the structure of the kidneys and urinary tract (weakness of the ligaments supporting the kidney);
8. Deficiency of substances that slow down crystallization (citrate, pyrophosphate, nephrocalcin, uropontin);
9. Inflammation in the renal pelvis;
10. Taking sulfonamides and tetracyclines, nitrofurans together with ascorbic and other acids.

The combination of several of these factors leads to the patient developing chronic crystalluria– a pathology in which crystals of various salts appear in the urine. Stone formation is a complication of this condition. Depending on the pH of the urine and the type of salts, various stones (clusters of crystals) begin to form. Usually their place of birth is the collecting ducts and pelvis.

The process of stone formation begins with the concentration of salts in the urine increasing and them becoming insoluble. The salts crystallize around a colloidal “core,” a large organic molecule that forms the basis of a kidney stone. Subsequently, new crystals form and grow on this matrix.

Recent studies have found that almost all stones (97%) contain nanobacteria, so named because of their small size. These atypical gram-negative (not stained by the Gram method) microorganisms produce apatite (calcium carbonate) during their life processes. This mineral is deposited on the walls of kidney cells, promoting crystal growth. Nanobacteria infect the epithelium of the collecting ducts and the areas of the renal papillae, creating centers of calcium phosphate crystallization around themselves, and thereby contribute to the growth of the stone.

Classification

The types of stones that are found in urolithiasis are classified according to etiology, location, composition, risk of re-formation, radiological characteristics, and quantity.

According to localization, stones of the kidneys, bladder and ureter are distinguished. Depending on the quantity, stones can be multiple (sand) or single. According to the chemical composition, stones can be phosphate, oxalate, urate, cystine, uric acid, xanthine, 2,8-dihydroxyadeine, struvite.

Most often, patients are diagnosed with the following four types of stones:

1. Calcium. In patients with urolithiasis, in 80% of cases calcium stones are found, which can have different texture, size and shape. Such stones for urolithiasis in men are diagnosed in cases where the patient’s age exceeds 50 years. There are phosphate, oxalate and carbonate stones. Calcium phosphate stones are less common in their pure form.
2. Urate. They are detected in only 6-10% of cases. Such stones consist of uric acid salts: ammonium and sodium urate, as well as uric acid dihydrate.
3. Struvite. These stones are formed due to infections of the urinary system and consist of waste products of infectious agents - magnesium-ammonium phosphates. Struvite stones are diagnosed in 10% of cases.
4. Cystine. Such stones are detected in 1% of all cases. They often form in patients with a genetic pathology, which is characterized by a violation of the process of excretion of the amino acid cystine.

Symptoms of urolithiasis in men and women

The main clinical manifestations of urolithiasis in men and women are associated with impaired urodynamics (impaired urine outflow) and/or an inflammatory process. On initial stages the disease may be asymptomatic. Moreover, the size of the stone is not always comparable to the severity of the complaints: the largest stones (staghorn stone) may not bother a person for a long time, while a relatively small stone in the ureter leads to renal colic with severe pain. Thus, clinical manifestations depend primarily on the location of the stone and the presence or absence of an inflammatory process.

Here are the main symptoms of urolithiasis:

• The pain can be acute (renal colic) or dull, aching. The cause of renal colic is a sudden disruption of the flow of urine from the kidney, as a result of obstruction of the ureter by a stone. The pain is sudden, with periods of relief and repeated attacks. The pain is localized in the kidney area or along the ureter and has a typical irradiation down to the iliac and inguinal region. Patients behave restlessly, unable to find a body position in which pain would decrease. Dull, aching pain is characteristic of the inflammatory process against the background of urolithiasis.
• Hematuria (blood in the urine) with urolithiasis occurs as a result of a sharp increase in intrapelvic pressure (with renal colic) with the formation of pyelovenous reflux (reflux of urine into the venous bed), which manifests itself as total gross hematuria after relief of renal colic. Also, when a stone passes through the ureter, injury to the latter is possible.
• Dysuria (impaired urination), in the form of frequent urination, is usually formed when the stone is located in the lower third of the ureter, urethra, or when there is a large stone in the bladder. For this reason, erroneous overdiagnosis of cystitis and prostatitis is possible. Difficulty urinating or interruption of urination can occur with stones in the bladder and urethra.
• Pyuria (leukocyturia): an increase in the number of leukocytes in the urine indicates the addition of a urinary tract infection.
• Postrenal anuria: lack of urine due to impaired urine outflow - possible in the presence of stones in both ureters or in the presence of a stone in the ureter of a single kidney. Postrenal anuria requires urgent treatment measures.

Complications

If there is no tendency to excrete stones over a long period of time, progressive inhibition of the functions of the urinary system occurs. The most common complications of urolithiasis in women include:

1. Anemia due to constant blood loss;
2. Chronic pyelonephritis. Such a complication may lead to the development of nephrosclerosis;
3. Pyonephrosis, which is a consequence of pyelonephritis of a purulent-destructive form, which is in the terminal stage of its development. A kidney affected by pyonephrosis consists of many cavities that are filled with urine, toxic agents and purulent exudate;
4. Acute renal failure. This complication occurs in rare cases when the patient is missing one kidney or has stones in both kidneys;
   Disorder of the hematopoietic functions of the kidneys;
5. Paranephritis, characterized by the presence of carbuncles, pustules or abscesses in the kidney tissue. This leads to the development of sepsis and is an indication for surgery;
6. Chronic inflammatory processes with foci of localization in the areas where stones are located. In unfavorable situations, for example, when the patient’s body becomes hypothermic or suffers from an acute respiratory infection, the inflammatory process can go into an exacerbation stage.

Diagnostics

The symptoms of urolithiasis are similar in their manifestations to the symptoms of other pathologies of the organs of the retroperitoneal region and abdominal cavity, therefore differential diagnosis is carried out to exclude the condition of an acute abdomen (ectopic pregnancy, colitis, acute appendicitis, radiculitis, ulcer, cholecystitis).

Diagnostic stages:

1. Examination and history taking. To identify the etiology and pathogenesis of the disease, the urologist needs information about the person’s type of activity, his eating style, the characteristics of the development and course of the disease, the use of medications, as well as previous operations, injuries, and long-term immobilizations.
2. Visualized study of stone. To visualize an insoluble formation, ultrasound examination of the excretory tract is used. This method allows you to identify both X-ray positive and X-ray negative stones. Spiral computed tomography, survey and excretory urography are also used to obtain information about the location, shape, composition of the stone and the condition of the urinary system.
3. Clinical studies include biochemistry, general blood and urine tests to identify the inflammatory process and the severity of renal failure. To determine sensitivity to antibiotics, microflora cultures are performed.
4. Examination of the kidneys using radioisotropic and biochemical methods.
5. Pneumopyelography, retrograde urethropyelography, urethropyeloscopy.
6. Study of tomographic density of formations to prevent possible complications.
7. Analysis of the resulting stone.

Differential diagnosis

Modern techniques make it possible to identify any type of stones, so it is usually not necessary to differentiate urolithiasis from other diseases. The need to carry out differential diagnosis may arise in an acute condition - renal colic.

Usually, diagnosing renal colic is not difficult. With an atypical course and right-sided localization of a stone causing obstruction of the urinary tract, it is sometimes necessary to carry out a differential diagnosis of renal colic in urolithiasis with acute cholecystitis or acute appendicitis. The diagnosis is based on the characteristic localization of pain, the presence of dysuric phenomena and changes in urine, and the absence of symptoms of peritoneal irritation.

There may be serious difficulties in differentiating between renal colic and renal infarction. In both cases, hematuria and severe pain in the lumbar region are noted. We should not forget that renal infarction is usually a consequence of cardiovascular diseases, which are characterized by rhythm disturbances (rheumatic heart defects, atherosclerosis). Dysuric phenomena during renal infarction occur extremely rarely, pain is less pronounced and almost never reaches the intensity that is characteristic of renal colic due to urolithiasis.

Treatment

Both surgical treatment methods and conservative therapy are used. Treatment tactics are determined by the urologist depending on the age and general condition of the patient, the location and size of the stone, the clinical course of urolithiasis, the presence of anatomical or physiological changes and the stage of renal failure.

General principles of treatment of urolithiasis:

1. Drink plenty of fluids. Whatever the causes of urolithiasis, concentrated urine promotes the formation of new stones or the “growth” of existing ones. In case of nephrolithiasis, at least 2 liters of fluid per day is recommended.
2. Diet. Depending on the nature of the pH and the prevailing salts, a diet is prescribed that helps dissolve small stones. The diet can either accelerate their dissolution or contribute to their formation and recurrence of urolithiasis even after the stone has passed.
3. Physical activity. Inactivity and a sedentary lifestyle provoke the formation of stones, and walking, running, and jumping lead to the removal of microliths.
4. Herbal medicine: diuretic, anti-inflammatory herbs.
5. Stone removal (surgical and conservative methods).

Drug treatment

The main clinical symptom of urolithiasis is pain due to renal colic. To stop an attack, the patient is prescribed analgesics and antispasmodics. In severe cases, when renal colic does not go away after taking the above drugs, the patient is administered narcotic analgesics.

Drugs that dissolve stones in the urinary system are prescribed in accordance with chemical composition stones. The course of treatment is usually long, but not less than 1 month. If complications develop in the form of pyelonephritis or inflammation in the bladder and urethra, the patient is prescribed an antibiotic, the dosage of which is selected strictly individually for each patient.

Indications for surgical intervention are the following conditions:

1. The size of the stones exceeds 5 cm in diameter;
2. The calculus blocked the lumen of the ureter and the patient’s urine flow was disrupted;
3. Ingrowth of a stone into the mucous membrane of the urinary tract;
4. Constant attacks of renal colic that last more than 60 minutes.

Phytotherapy

During the treatment of urolithiasis, a number of herbal medicines are used. Medicinal herbs are used to accelerate the passage of sand and stone fragments after extracorporeal lithotripsy, and also as a prophylactic agent to improve the condition of the urinary system and normalize metabolic processes.

Some herbal preparations help increase the concentration of protective colloids in the urine, which prevent the process of salt crystallization and help prevent relapse of urolithiasis.

Spa treatment

Sanatorium-resort treatment is indicated for urolithiasis both in the absence of a stone (after its removal or spontaneous passage) and in the presence of a stone. It is effective for kidney stones, the size and shape of which, as well as the condition of the urinary tract, allow us to hope for their spontaneous passage under the influence of the diuretic effect of mineral waters.

Patients with uric acid and calcium oxalate urolithiasis are treated at resorts with low-mineralized alkaline mineral waters:

• Zheleznovodsk (“Slavyanovskaya”, “Smirnovskaya”);
• Essentuki (Essentuki No. 4, 17);
• Pyatigorsk, Kislovodsk (Narzan).

For calcium oxalate urolithiasis, treatment at the Truskavets (Naftusya) resort, where the mineral water is slightly acidic and low-mineralized, may also be indicated.

Treatment at resorts is possible at any time of the year. The use of similar bottled mineral waters does not replace a stay at the resort.

Reception of the above mineral waters, as well as mineral water"Tib-2" (North Ossetia) for therapeutic and prophylactic purposes is possible in an amount of no more than 0.5 l/day under strict laboratory control of the metabolism of stone-forming substances.

Physical exercise

Physical activity is one of the elements in the fight against the accumulation of harmful salts. During treatment and the rehabilitation period, moderate exercise is useful. The doctor prescribes special gymnastics - exercise therapy. The complex is designed so as not to overload the body, but to work out the necessary departments.

Useful exercises:

• for stretching;
• for the abdominals, buttocks and thighs;
• for back muscles;
• swimming;
• walking;
• a ride on the bicycle;
• skiing;
• general strengthening exercises.

On a note! It is useful to take a knee-elbow position for a third of an hour every day. During exercise, the outflow of fluid from the lower part of the kidneys improves.

Surgical treatment

Large urinary stones that cannot be dissolved are broken into small fragments, which either come out on their own or are removed surgically. Stones are destroyed by lithotripsy, affecting them with a shock wave.

There are several types of lithotripsy:

1. ESWL– external shock wave lithotripsy is a non-invasive method in which the impact on kidney stones is carried out without any skin incisions or other invasive techniques.
2. Contact lithotripsy– an endoscopic device is brought to the stone through the urethra and bladder, the active part of which comes into contact with the stone (that’s why the method is called contact). A shock wave is formed at the point of contact.
3. Percutaneous lithotripsy– with this technique, a lithotripter is inserted into the kidney through an incision in the lumbar region. Used for crushing giant and coral-shaped stones.

In cases where the stone cannot be crushed, surgery is performed. Depending on the volume of the operation, the following types of operations for urolithiasis are distinguished:

1. Pyelolithotomy– the stone is removed from the kidney through a small incision in the renal pelvis.
2. Nephrolithotomy– the incision is made directly through the kidney. This operation is indicated for stones that cannot be removed by other methods and when lithotripsy is ineffective. It is the most difficult operation for the patient.
3. Ureterolithotripsy– surgery to remove a stone from the ureter.

Diet for urolithiasis

Compliance with the principles of therapeutic nutrition for kidney stones is extremely important because:

• helps prevent the formation of new stones;
• dissolves existing stones;
• removes stones in the form of salt deposits and small formations from the kidneys.

In addition, a diet for urolithiasis is useful for weight loss and normalizes the functioning of the digestive tract and cardiovascular system. If a patient with kidney stones adheres to a therapeutic diet, the risk of inflammatory diseases of the urinary system is reduced.

Urats

Explanations	Dietary recommendations
Products rich in purines: animal and fish meat, offal, mushrooms, legumes, meat broths. It is recommended to consume dishes from them no more than once a week.	Limiting the consumption of foods containing purines - molecules that make up nucleic acids. Purines are mainly found in meat products.
Patients with uric acid stones should not drink beer or red wine.	Limiting the consumption of foods that interfere with the excretion of uric acid in the urine. Alcohol has this ability.
Recommended Products: mild cheeses; tomatoes; potato; Bell pepper; buckwheat; seeds and nuts; eggplant; fruits and berries; millet; barley grits; pasta; cottage cheese; eggs.	The patient's diet should consist mainly of foods that do not contain purines: vegetables and fruits, milk and dairy products, eggs.

Oxalates

Explanations	Dietary recommendations
Limit in your diet: carrot; beef; chicken; sauerkraut; sorrel; sour apples; lemons, oranges and other citrus fruits; currants; tomatoes beets; spinach; salad; Coffee and tea; parsley; celery; jellies; jelly; cocoa and chocolate; beans (green).	According to their chemical structure, oxalates are compounds of oxalic acid. Therefore, for oxalate urolithiasis, sorrel and foods rich in vitamin C are limited.
Authorized products: dairy products; cereals; watermelons; bananas; apricots; pears; peas; pumpkin; cabbage; potato; whole grains; potato; nuts;	Including a large amount of food rich in magnesium, calcium, and vitamin B6 in your diet.

Phosphates and struvites

Products that should be limited in case of phosphate urinary stones: cowberry; currant; cranberry; limit consumption of all vegetables and fruits; milk and fermented milk products; cheeses and cottage cheese.	Limiting foods containing large amounts of calcium and alkaline reaction. Phosphates are calcium salts that form most intensively in an alkaline environment.
Limit intake of the following products: carbonated drinks; hot spices; coffee; alcohol.	Limit foods that increase the production of gastric juice. The more hydrochloric acid is formed, the more acidic ions the body loses. This leads to additional alkalization of urine.
Consuming large amounts of salt causes the body to lose large amounts of calcium through urine.	Limiting salt in the diet.
Recommended Products: butter; vegetable oil; various soups; bread; pasta; meat; fish.	Increase the amount of foods in your diet that contain small amounts of calcium and are acidic. Increase your vitamin A intake.
Juices and fruit drinks made from sour fruits and berries (apples, citrus fruits, cranberries, etc.) are recommended.	Drinking acidic drinks. They help increase the acidity of urine and prevent the formation of phosphates.

Cystine stones

By-products: liver; spleen; kidneys, etc.	Products high in cystine are strictly prohibited.
meat and fish: 200–250 mg daily are allowed, no more than 5 days a week; eggs: no more than 1 pc. in a day; legumes; Wheat flour.	It is necessary to limit foods that contain cystine in sufficiently large quantities.
watermelon; oranges; quince; grape; cowberry; pear; olives; dogwood; mandarin; Rowan; nuts; carrot; apples; blueberry; currant; Birch juice; pear; pomegranate; raisin; lemon; strawberry.	Increase the content of foods rich in vitamins and biologically active substances in your diet.

Prevention

In order to minimize the risk of developing the disease in patients at risk, it is necessary to adhere to the following measures:

• nutrition should be complete, rational and sufficiently fortified;
• It is better to completely exclude “food waste” from the diet, namely fast food and semi-finished products;
• it is important to drink enough fluid daily (at least 2-2.5 liters);
• Work in hot shops or hot rooms is not recommended; sleep and rest should be complete;
• Particular importance is given to the timely diagnosis and treatment of any diseases of the urinary tract, as well as other body systems (endocrinopathies, gastrointestinal diseases, etc.).

If you experience the slightest discomfort or pain in the abdomen, lower back or lower extremities, immediately contact a urologist. By adhering to preventive measures, you will reduce the risk of developing urolithiasis to a minimum.