Urolithiasis: causes, features of the course, diagnosis and treatment of the disease
Mar 25, 2018
Urolithiasis is a disease characterized by the appearance of hard stone-like formations in the urinary organs( kidneys, ureters, bladder).Essentially, urinary stones are crystals that are formed from salts dissolved in the urine.
The appearance of foreign bodies in the urinary tract leads to damage to the mucosa and inflammation that causes a typical clinical picture of the disease.Table of contents: Causes of urolithiasis Urolithiasis: symptoms of the disease Treatment of urolithiasis
Causes of urolithiasis
This disease is poly-physiological, that is, several factors lead to its development.Most often, urolithiasis develops in people aged 20-45 years, with men suffering from it 2.5-3 times more often than women.
Factors favoring stone formation in the kidneys include:
- genetic predisposition;
- drinking water, rich in certain mineral salts;
- insufficient water regime - consumption of a small amount of liquid;
- is a sedentary lifestyle;
- eating foods rich in purine compounds( meat, vegetable - spinach, beans).
A special place among the causes of urolithiasis is occupied by diseases of different organs:
- Infectious-inflammatory diseases of the urinary tract: pyelonephritis, cystitis, urethritis.
- Diseases of the stomach and other organs of the digestive tract: hepatitis, gastritis, pancreatitis and others.
- Congenital and acquired anomalies of the kidneys and ureters.
- Metabolic diseases: gout, hyperparathyroidism.
All the above conditions lead to a change in the acid-base equilibrium in the body, which leads to the formation of kidney stones.
Urolithiasis: symptoms of the disease
Symptoms of urolithiasis vary in their variety - from the complete absence of clinical symptoms to such serious phenomena as renal colic and the kidney block.
Leading symptoms of urolithiasis, or what the patients complain about:
- burning and carvings above the pubis and in the urethra when urinating - explained by the spontaneous release of small pebbles, the so-called "sand";
- back pain associated with a sharp change in body position, a sharp shake-up, a plentiful drink( especially after consuming liquids such as beer and pickles).Pain occurs due to a slight displacement of stones;
- hyperthermia( high temperature) - indicates a pronounced inflammatory reaction to the stone in the place of its contact with the mucous membranes, as well as the attachment of infectious complications;
- Renal colic - the most unpleasant complication of urolithiasis, manifested by severe pain in the lower back with irradiation( spread) of them along the ureter, irradiation of pain in the leg, in the abdomen;
- patients often note turbidity of urine, as well as the appearance of blood in it( characteristic of renal colic).
The nature of the pain and its location can give the doctor information about the location of the stones: in the kidney itself, the ureter or the bladder.X-ray and ultrasound can help confirm this assumption.
At the earliest stages, the disease may not be manifested - kidney stones are often detected accidentally while undergoing a physical examination.Sometimes even large stones do not manifest themselves until the patient experiences an attack of renal colic.
Treatment of urolithiasis
In the therapy of urolithiasis, both conservative methods are used - with the help of tablets and injections, and surgical - to perform operations to remove stones.
Conservative treatment of urolithiasis
To eliminate the pain syndrome, analgesics are used, even narcotic drugs can be used in the ambulance and in the hospital.Pain relieves also spasmolytic drugs - on the background of good antispasmodic therapy, the stone can go out on its own.
For the dissolution of stones, drugs that alter the acid-base balance of the blood and change the acidity of urine are used.The drug is selected taking into account the type of concrements, which are of several types: cystine, oxalate, phosphate.
For the dissolution of cystine stones, Tiapramine, Uralit;Oxalate - Prolith, renal collection number 7 and 8;Phosphate - Marilin.
Important: is selected by the urologist or nephrologist based on the patient's urine and blood tests!
From conservative treatment methods, physiotherapy is also used: patients are prescribed magneto-therapy, amplipulse therapy, inductothermy and other methods.
Urolithiasis: home treatment
At home, in the absence of pain syndrome, as well as for the prevention of recurrences, you can use folk methods.With phosphate stones, the effect is noted with regular drinking of rose hips or barberry.Combined herbal preparations consisting of several herbs with moderate diuretic, spasmolytic and uroseptic action are also used.
Important: can only be given by an attending physician!
With urate stones, you can use oat broth.With cystine and struvite stones, folk methods in the treatment of urolithiasis are ineffective, as well as conservative treatment, since these stones are almost insoluble.
Large urinary stones that can not be dissolved can be broken down into small fragments that either leave themselves or are removed surgically.Destroy the stones through lithotripsy, acting on them with a shock wave.There are several types of lithotripsy:
- ESWL - Remote shock wave lithotripsy is a non-invasive method in which the impact on the stone in the kidney is carried out without any skin incisions and other invasive techniques.
- Contact lithotripsy - through the urethra and urinary bladder, an endoscopic device is applied to the stone, the active part of which comes into contact with the calculus( therefore the method is called the contact method).A shock wave is formed at the contact point.
- Percutaneous lithotripsy - with this technique, the lithotriptor is injected into the kidney through a cut on the lumbar region.It is used for crushing giant and coral stones.
In the event that the stone can not be shredded, a surgical operation is performed. Depending on the volume of the operation, the following types of operations for urolithiasis are distinguished:
- Pyelolithotomy - a calculus from the kidney is removed through a small incision of the renal pelvis.
- Nephrolithotomy - an incision is made directly through the kidney.This operation is indicated for stones that can not be removed by other methods and when lithotripsy is ineffective.It is the most difficult operation for the patient.
- Ureterolitotripsiya - an operation to remove the stone from the ureter.
Prevention of urolithiasis
It is easier to prevent stone formation in the kidneys than to treat them later.There is a whole complex of preventive measures aimed at reducing the rate of stone formation and getting rid of them.To adhere to simple advice on prevention is recommended for all patients who have at least once had an attack of renal colic.
Advice on prevention:
- The correct drinking regime.The daily water consumption should be at the level of two liters.In summer you can increase this volume to three liters.But you need to consult a doctor first, since in some diseases of the heart a large amount of fluid is contraindicated.
- Prevention of dehydration( dehydration).In extreme conditions( in heat, during sports, during diseases with high temperature), you should drink more liquid in small portions of 100-150 grams every half hour-hour.
- Diet for urolithiasis.A balanced diet, in which the ratio of different types of meat, dairy and plant products is selected individually, reduces the risk of stone formation.Ideally, a doctor should choose a diet.The food needs a sufficient content of microelements and vitamins of different groups.If necessary, you can take multivitaminic complexes and dietary supplements.
Diet option for urolithiasis:
- Limitation of salt intake.It is better to nedosalivat food than transplant it.Excess of table salt gives a load on the kidneys, provoking urolithiasis.
- Physical activity.The load on the abdominal and back muscles improves renal blood flow, which stimulates metabolic processes in the kidneys and improves their detoxification function.
- Timely treatment of diseases.Pay attention to the gastrointestinal tract and the endocrine system - these organ systems should be periodically examined, as violations in their work are one of the leading factors predisposing to urolithiasis.
- Prevention of diseases of the genitourinary system.Pyelonephritis and urethritis can cause an exacerbation of urolithiasis, so it is better not to get sick, but when symptoms of the disease start healing.
- Sanatorium treatment for . Patients with kidney stone disease in the period of remission 1-2 times a year are recommended to visit resorts where mineral waters are treated.This is one of the most effective methods of prevention.In Russia, dispensaries, specializing in the treatment of this disease, are in Kislovodsk, Pyatigorsk, Zheleznovodsk.Specific sanatorium will help to choose a doctor, as for each type of stones fit certain mineral water.
Complications of urolithiasis
Untimely treatment and abuse of folk methods of treatment of urolithiasis without consulting a doctor can lead to serious complications from the urethra.
Complications often occur:
- Infections of the urethra not only can provoke urolithiasis, they can be its complication.Often against the background of the disease arise: pyelonephritis, cystitis, urethritis.
- Kidney block and hydronephrosis - obstruction of the ureteral calculus makes urine outflow impossible.As a result, it accumulates in the kidney, causing it to increase.This condition can lead to kidney failure http: //okeydoc.ru/ ostraya-pochechnaya-nedostatochnost-simptomy-prichiny-neotlozhnaya-pomoshh / and kidney loss.
- Nephrogenous hypertension.Against the background of renal pathology, there is often an uncontrolled increase in blood pressure - symptomatic hypertension.
- Nephrosclerosis is a rebirth of the kidney tissue due to a permanent impairment of urine metabolism.This is the most common cause of chronic kidney failure.
- Purulent complications arising from the ingress of pathogenic microorganisms into the kidney( abscess and pionephrosis).Kidney stones aggravate the course of these diseases, and they can lead to septic shock and death.
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