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How is the removal of stones from the bladder?

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Urolithiasis is a pathology caused by a metabolic disorder, which causes the formation of stones in the urinary tract. Most often, concrements appear in the kidneys, ureters, bladder.

Urolithiasis in men

Most often, urolithiasis is accompanied by pain in the groin and lower back, but there is also an asymptomatic course of the

disease. Contents

  • 1 Urolithiasis: a brief description of
  • 2 Symptoms of the disease
  • 3 Treatment methods
    • 3.1 Remote lithotripsy
    • 3.2 Contact cystolitotripsy
    • 3.3 Cystolithotomy
  • 4 PossibleComplications and prevention measures

Urolithiasis: a brief description of

From stones in the bladder, mostly men over 50Years and boys under the age of 7 years. This statistic is due to various diseases of the urethra in adult men and the narrowness of the urethra in children.

There are single and multiple stones. By their nature concrements are :

  • primary( formed directly in the bladder cavity);
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  • secondary( have got into the bladder with a current of urine from the kidneys or kidney loaches.).

For reasons stone formation in the urinary bladder in men include:

  • impairment of emptying the organ of various etiologies( prostatic hypertrophy, prostatic sclerosis, bladder neck stenosis, neurogenic pathologies, narrowing at various levels of the ureters);
  • kidney or ureter kidney stones;
  • presence of foreign body in the organ;
  • cystoptosis or protrusion of the organ wall;
  • any abnormalities in the anatomy of the urinary system;
  • infection of the urinary system;
  • long-term presence of drainage in the urinary tract

Symptoms of the disease

Symptomatic and clinical course of the disease depends on the degree of movement of stones in the organ and their localization. Cystolithiasis is inherent, the so-called triad of symptoms: pain, hematuria( the appearance of traces of blood in the urine), the removal of the stone with urine. Sometimes in patients there are only one or two symptoms.

It happens that urolithiasis is asymptomatic. This latent course of the disease is typical for large stones that do not interfere with a normal outflow of urine.

Small stones, clogging the urethra, cause severe pain. Perhaps increased pain during the movement. A reliable sign, indicating the presence of concrements in the bladder, is the interruption of the jet during the process of urination. In this case, the urination passes normally in the horizontal position of the patient, so in some cases patients with cystolithiasis can only urinate while lying down. If the stone wedges into the neck of the organ or gets into the urethra, there will be an acute delay in urination.

Treatment methods

Treatment of cystolithiasis includes:

  • pain relief;
  • normalization of urinary excretion;
  • stone-throwing therapy, or destruction and removal of concrements;
  • warning of various complications;
  • preventive measures to prevent the formation of new stones.

Stone therapy is suitable for concrements not exceeding 4 mm in diameter. Only with this size of a stone is possible its spontaneous departure. In those cases where the stones in the bladder are larger, their removal is shown.

At the moment, the following methods for removal of stones from the bladder are practiced:

  • Remote Cystolithotripsy;
  • contact cystolithripsy;
  • cystolithotomy.

Cysticotripsy - is the crushing of stones, cislitotomy - stone-cutting.

Remote lithotripsy

A method based on the effect of a focused and directed shock wave on a stone causing its destruction. The lithotripter is represented by a shock wave generator, a focusing and targeting system on a foreign body. Localization and focusing occurs through the beam guidance( X-ray and / or ultrasound).This method of breaking stones is suitable if they do not exceed 1.5 cm in diameter.

In addition to limiting the use of the method to the size of calculi, there are a number of contraindications to remote lithotripsy.

Remote lithotripsy as a method of controlling stones in the bladder

Remote lithotripsy - a method of treatment of urolithiasis, based on the hardware crushing stones with shock wave

Technical contraindications :

  • the patient's body weight is more than 200 kg;
  • growth is more than 2 m;
  • disorders of the musculoskeletal system, which do not allow for accurate focusing.

General medical contraindications :

  • pregnancy;
  • poor blood coagulability;
  • is a serious disorder of the heart.

Urological indication:

  • acute inflammatory processes of the urinary system;
  • severe renal insufficiency;
  • obstruction of the urinary tract below the stone.
After the procedure, for some time, pain in the lumbar region may be present. On the background of intervention, sometimes vomiting occurs, in severe cases, the development of hematuria is possible.

Contact cystolithotripsy

Second in frequency after remote. This operation is carried out by introducing a special endoscope through the urethra, which destroys the stones to a small size and flushes its remains. The method is considered non-invasive, since it does not break the integrity of the skin. The procedure is performed under local or spinal anesthesia. Cystolithotripsy can be the following species ( depending on the method of destruction of stones):

  • ultrasound;
  • laser;
  • pneumatic.

The most effective type of contact lithotripsy is laser. Ultrasound lithotripsy works only on low density stones. When pneumatic( for concrements, compressed air is applied), cystolithotripsy may damage the soft tissues. There is a possibility of casting the remains of stones in the kidneys.

There are also several contraindications to contact cystolithotripsy.

Method of removal of bladder stones - contact cystolithotripsy

Method of contact cystolithotripsy:
1 - endoscope;
2 - prostate;
3 - stones of the bladder.

General medical contraindications:

  • presence of pacemaker;
  • acute respiratory failure;
  • pregnancy;
  • diseases of the gastrointestinal tract during an exacerbation.

Urologic contraindications:

  • inflammation in the urethra;
  • small volume of the bladder;
  • prostatitis.
Laparoscopic and, moreover, operations on the open peritoneum are extremely rare. Remote and contact methods of cystolithotripsy proved to be very useful.

Cystolithotomy

But, in some cases, an open operation can still be assigned. Indications for such interventions are:

  • anatomical features of the bladder;
  • acute inflammation of the urethra;
  • large size of the stone.

Cystolithotomy , performed under general anesthesia. After intervening for a while, the bladder is catheterized. Unpleasant side effects of this procedure are: a large incision, operational risks, a long period of rehabilitation. But there are also advantages of cystolithotomy: fast result, absence of urethra injury( which is especially important for children).

Possible complications and prevention measures

Complications after removal of stones, as a rule, do not happen. In rare cases, it is possible to attach a secondary infection, the development of postoperative bleeding. For men's health, the removal of stones from the bladder is not affected. The forecast of operations is favorable. With the elimination of the underlying disease, recurrent stone formation does not occur.

As measures to prevent the development of urolithiasis, men are recommended to drink at least 2.5-3 liters of water per day, consume less salt and animal protein. It is necessary to comply with diet, limit stress and follow a balanced loss of fluid. A specialist can be assigned a special diet.

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