What causes a stone in the bladder. Bladder stones. Treatment for bladder stones

Urolithiasis in women, symptoms and treatment are not much different from the disease in men, but they have their own characteristics. In medical statistics, this pathology of the urinary organs is one of the first places in terms of prevalence. In men, it occurs more often, due to the peculiarities of the male anatomy, but women also often encounter it, while female uniform disease has a number of distinctive features and characteristics. What is urolithiasis in a woman - symptoms and treatment, causes and possible complications, diagnostic methods?

Description and pathogenesis

As mentioned earlier, the pathology in question is one of the most common disorders of the genitourinary system, up to 13 percent of all pathologies of these organs are due to urolithiasis. The disease itself is a disorder of metabolic processes, in which salt crystals precipitate and increase in the urinary organs, gradually forming larger stones. In absolute terms, up to 6 percent of the world's population suffers from this disease.

Concrements, often called stones, in men usually have a fairly simple shape - in the form of smooth or uneven stones and sand. In women, formations take on a more complex form - convoluted, also called "coral". Forming and growing, they are able to fill the calyx-pelvic system in whole or in part, which will lead to the need for resection of the kidney or its complete removal. A stone can also form in bladder.

In all patients with urolithiasis, the number of calculi can be very different. For example, a unique case is known when about five thousand stones were removed from a patient in one operation, some of which reached ten centimeters in diameter. The lesions can appear in one kidney or involve both sides.

Urolithiasis has no “age preference”; it can even appear in children, although older people are at risk.

Despite the significant amount of accumulated last years medical data, the exact reasons for the appearance of urolithiasis in women have not been established.

But doctors suggest some probable factors leading to the development of pathology:

• genetic predisposition and congenital kidney disease. These include anomalies in the development of organs, polycystic disease, etc., which lead to a deterioration in urine drainage and stagnation. Stagnation, in turn, provokes stone formation;
• chronic inflammation kidney infectious genesis: glomerulonephritis, cystitis, pyelonephritis. With them, an increased amount of protein is observed in the urine, on the molecules of which salt crystals are deposited, triggering the formation of stones;
• metabolic disorders. Problems with calcium metabolism, arising against the background of fractures, metabolic disorders, gastrointestinal disorders, malnutrition and inactivity, can provoke urolithiasis;
• a large amount of meat in the diet;
• environmental factors;
• prolapse of the kidney;
• hydronephrosis of various origins, and other reasons.

There are two key factors provoking the disease:

1. High concentration of protein molecules in the urine.
2. Increased level of salts in the liquid.

Heredity plays an important role.

Stone formation does not start suddenly, it is a rather long process that takes place over months and years. As a rule, it occurs against the background of chronic renal pathologies, leading to the appearance of the two factors described above. After a while, the "sand" formed at the initial stages becomes overgrown with deposits, turning into calculi up to ten centimeters in size, symptoms of stones in the bladder develop.

Small kidney stones, small bladder stones in women are able to leave on their own during urination (albeit giving the patient discomfort and pain), as the size of the formations increases, they reduce the lumen of the urinary ducts, up to their complete blockage, stopping the excretion of urine from the body.

This condition, if left untreated, can cause uremia and subsequent death of the patient.

Symptoms

Symptoms of stones in the bladder, calculi in the kidneys and the intensity of the manifestations of pathology largely depend on the size of the formations in the urinary system.

Usually, patients complain of the following signs of urolithiasis:

• feeling overwhelmed;
• vomiting;
• general malaise;
• poor appetite;
• increased pressure;
• the labia become sore;
• cramps, pain and burning during urination.

In general, the symptoms in women are similar to those in men. So, the urge to urinate may become more frequent, but at the same time, the fluid itself either does not occur, or it is minimal. There is no sense of relief when you try to empty your bladder. Another characteristic symptom is high fever. Blood tests taken from patients show that there is a high white blood cell count, indicating acute inflammation.

If the problem is not dealt with, then acute pain in the lumbar region is added to the symptoms, which sometimes becomes unbearable (this happens when the stone goes along the ureter). In this case, to alleviate the patient's condition, it is necessary to stop the syndrome with non-narcotic painkillers.

The main symptom is pain. It occurs in the lower back and lower abdomen, and radiates to the labia. The intensity of the pain syndrome varies from very strong to almost imperceptible, but the pain does not completely go away. When stones begin to move along the ducts, there is acute renal colic with sharp pains, lasting up to one hour.

Beating the edge of the hand along the lower back in the region of the kidneys delivers to the patient discomfort, hand feeling also causes pain on the side of the affected kidney.

Another symptom is a pinkish color of urine due to the presence of blood in it. This occurs as a result of damage inner surface urinary tract when stones pass through them or during inflammation.

In rare cases, the symptoms of urolithiasis in women are completely absent, then the stones are found ultrasound examination and other diagnostic methods.

Possible complications

When stones remain in the kidneys, urinary ducts for a long time, this condition can be fraught with serious complications.

The most difficult of them is kidney necrosis and its death due to intoxication and cell death.

Among other, no less dangerous consequences:

• chronic pyelonephritis. With it, pulling pains in the lower back and abdomen are felt, sometimes the temperature rises;
• a dangerous complication is chronic cystitis. Stones in the bladder often lead to a decrease in immunity, and mucosal injuries and the effects of other negative factors (acute respiratory infections, hypothermia) can cause acute inflammation of the tissues of the bladder, turning into chronic;
• a type of cystitis is hypertrophic. The stones in the bladder grow with it, the muscles of the organ and its mucous membrane are hypertrophied;
• acute pyelonephritis. With it, pathogenic microflora multiplies very quickly in urine. The body temperature rises and severe kidney inflammation develops. This state is indicated by general weakness patient, as well as renal colic;
• advanced urolithiasis without proper therapeutic procedures leads to kidney damage: sepsis, the appearance of pustular foci, organ tissue abscess, paranephritis, pathologies reproductive organs... These conditions require immediate reaction- restoration of normal urine output, kidney sanitation, in difficult situations, organ removal is indicated;
• inflammation of the urethra - urethritis;
• pyonephrosis. This is a severe stage of purulent tissue damage, in which the kidney undergoes so-called purulent fusion. At this stage, the organ completely loses its function, turning into a shell with cavities inside, filled with uroliths, stagnant urine and purulent contents;

In chronic renal failure, chronic pyelonephritis is resolved with improper therapy or its absence, and against the background of two other factors: inflammation of the renal tissues and the transience of the disease.

Treatment and diagnostics

Symptoms of stones in the bladder in women, as well as in the stronger sex, may be similar to signs of other pathologies, so it is important for the doctor to carry out a differential diagnosis that excludes errors.

Conditions similar to those of bladder stones include:

• acute inflammation of the appendix;
• the state of pregnancy, proceeding with pathologies and anomalies;
• exacerbation of chronic gastric ulcer;
• gallstone syndrome.

The effectiveness and success of therapy for urolithiasis in women largely depend on the thoroughness of the examination of the patient and the accuracy of the diagnosis. The methods of dealing with the disease chosen by a specialist also depend on them.

It is also important to understand that the treatment of urolithiasis in women is similar to the treatment of this syndrome in men, with only some physiological differences.

The diagnosis is made based on analyzes of urine and blood samples.

In addition to them, it is done:

• Ultrasound of the urinary organs (it is important to remember that ultrasound may not detect all available stones);
• survey urography, in which data are obtained on the shape, size, location and density of the calculus;
• excretory urography: the patient is injected intravenously with a contrast agent, and according to the filling defect in the place of the proposed location of the stone, it is precisely established.

The urologist interviews the patient, drawing up an anamnesis: he finds out the lifestyle, the presence of background diseases and possible hereditary factors, the daily routine and diet of his ward, finds out what symptoms are present. It is important to know whether there have been previous surgical operations, whether medications are being taken, whether congenital genitourinary abnormalities, organ infections.

Treatment of urolithiasis in women has two goals:

1. Withdrawal of symptoms.
2. Elimination of stones and the very reason for their formation.

If a woman experiences kidney colic, bed rest is indicated. Heat is applied to the lower back (it can be a heating pad, or the area is wrapped up warmly), short-term (up to 10 minutes) hot baths show themselves well. The doctor may also prescribe antispasmodics into the muscles or intravenously, which will help remove the stone from the ureter. The number of antispasmodics includes such drugs as proven over the years No-shpa, Maxigan, Baralgin and derivatives.

Urolithiasis in women implies both conservative and surgery.

To quickly relieve pain, intramuscularly use:

• Dicloran;
• Voltaren;
• Analgin mixed with papaverine.

Anti-inflammatory therapy may be needed. This is due to the fact that uroliths (kidney stones) are formed in the calyx and pelvis of the kidneys. When the stones are large enough, they block the ducts, blocking the flow of urine. And since these formations often have an uneven shape with sharp edges, they injure the mucous membranes. Bacteria enter the injured area, causing inflammation, hydronephrosis develops. This condition requires active antibiotic therapy.

Before it begins, a specialist makes a urine culture, determining its sterility and the presence of pathogenic microflora in the liquid. The sensitivity of pathogens to certain antibiotics is being investigated.

Having received a certain result, the doctor chooses the necessary treatment strategy. In general, treatment for urolithiasis in women is similar to that in male patients.

Anti-inflammatory drugs used:

• Cephalexin;
• Ceftriaxone;
• Efz and others.

If urolithiasis occurs against the background of pyelonephritis, it is required to stimulate renal microcirculation. For this purpose, Agapurin, Trental and a number of other names of medicines are used. Also used are drugs of the nitrofurin, sulfanilamide series, etc., at the option and at the discretion of the attending physician.

But conservative drug therapy is only appropriate in mild cases. If the stones are large, and the disease is severely neglected, a more serious intervention may be required - surgery.

Removal of stones is done different ways:

• the most common method in the past was an abdominal operation with opening the peritoneum and manual extraction of uroliths;
• sparing laparoscopic surgery, in which the stone is removed through small incisions using special instruments. In comparison with abdominal, such an intervention is less invasive, and patients after it recover much faster;
• distance lithotripsy, when uroliths are crushed by a shock wave. This is the most gentle, but also the most difficult and expensive treatment option, in which there is no penetration into the abdominal cavity at all. The calculus is crushed by a shock wave using a special apparatus and excreted in the urine;
• transurethral techniques: removal is performed with special instruments inserted through the urethra.

In cases of severe lesions, when stones have occupied a significant volume of the kidney, or complications have caused tissue damage with their necrosis, resection or complete removal of organs may be indicated.

pochki2.ru

Bladder stones: symptoms, diagnosis, treatment:

A problem that often requires surgery is urolithiasis. Bladder stones, the symptoms of which do not appear immediately, most often concern males. The size, chemical composition and type of calculi may vary.

Where do they come from?

Sand in the bladder can travel from the kidneys. The same goes for stones. This variety is also called secondary. Concrements can be primary, that is, arising directly in the bladder. The causes of the onset of the disease can be:

• pathological conditions leading to a violation of normal urination: fluid is retained, which contributes to the appearance of salt crystals, and then stones;
• the consequences of surgical intervention;
• violation of innervation;
• congenital and acquired defects of the bladder;
• neoplasms, foreign bodies;
• schistosomiasis;
• inflammatory processes;
• prolapse of the bladder along with the uterus in women.

Symptoms

As mentioned above, even if bladder stones have formed, symptoms do not appear immediately. It is possible to identify calculi using special medical equipment. The symptoms most commonly reported with bladder stones are:

• pain in the lower abdomen (worse when walking or active movement);
• an increase in the frequency of urination (mainly during the day) or their delay (with the appearance of large stones);
• blood in the urine;
• uncontrolled urination (in not a large number);
• interruption of the urine stream.

Diagnostics

Only with the help of certain examination methods can stones in the bladder be detected. The symptoms and complaints of the patient are important for the diagnosis, however, the general analysis of urine is also taken into account (erythrocytes and leukocytes in this case are increased), bacteriological culture (helps to establish the presence / absence of bacteria), as well as the results of ultrasound (usually with the help of it you can even find small pebbles, as well as their location). Detailed information about the disease can be obtained through urethrocystoscopy. This instrumental method also allows you to assess the condition of the mucous membrane of the bladder. Among other research methods that help identify stones in the bladder (symptoms, we repeat, do not appear in all cases), - and excretory urography, and radiography, and computed tomography.

Treatment

Bladder stones can be removed using the following methods:

1. Stone crushing.
2. Lithotomy.

The first involves the introduction into the bladder of a special instrument for crushing. These can be electrohydraulic, ultrasonic or pneumatic lithotripters. After crushing the stone, its particles are removed. Stone cutting involves already a surgical operation. Stones are rarely removed through the abdominal cavity, the suprapubic extra-abdominal incision prevails. If the stones are very small, doctors suggest that the patient drink a large amount of liquid so that the stones will come out on their own.

www.syl.ru

Kidney and bladder stones, treatment with folk remedies, symptoms, causes, signs

Medicine in the case of her distinguishes and takes into account where exactly the focus of stone formation is located. But, depending on the specific scenario, the prescribed treatment may apply both only to this focus, and to all urinary tract. As a rule, the focus is located in the kidneys - in both or in one, in a certain part of the organ or in several parts of it at the same time. Naturally, kidney stones are inevitably washed out from there into the bladder. Not everything, of course, - it directly depends on the size and degree of mobility of the stone. However, a certain percentage of them always leave the kidneys.

Cases when stones occur directly in the bladder are also by no means rare. Nevertheless, they are less common than, in fact, kidney stones. The fact is that if stones have arisen in the bladder, differentiation by the place of their formation makes sense - after all, the kidneys do not need to be treated, since they are not affected. If stones occur in the kidneys, this process will in any case affect the ureters, and the bladder, and the urethra. In this case, the entire urinary system will still have to be treated. And the place of localization of the main process, as we understand, will lose part of its significance due to this.

So, if we have kidney stones, they will also be in the bladder. If not, putting an “and” between these two words is not entirely correct. Urolithiasis can begin with us for various reasons. However, her symptoms, milestones and results are always the same. The difference is that, depending on the cause and location, it will spread faster or slower. Accordingly, this creates a certain difference in the severity and variety of symptoms of the initial stage.

For example, we understand that a kidney stone, if it is motionless (it is alone, it is too large, etc.), may not make itself felt for a long time. And the parts of the urinary system located below (ureters, bladder, urethra) will not be affected by its presence. In this scenario, all that we can feel in the first ten years from the moment of its appearance is limited to periodic renal colic. And then only after drinking a lot or driving on a shaky road. For a long time, these spontaneous "ailments" from the kidneys will go away on their own, quickly, without a trace and for a long time. The stone will grow and, of course, we will end up on the operating table anyway. It's just that no one knows when it will happen.

Another thing is small, movable stones or sand in general. Neoplasms of this type always give symptoms early. And these symptoms are so pronounced that they literally force the patient to seek help. Small stones and sand, regularly leaving the kidneys with urine flow, cause the development of secondary inflammation throughout the urinary system in months - a maximum of six months. We can be sure that kidney stones in combination with cystitis, as well as an admixture of blood and visible sediment in the urine cannot be overlooked.

Symptoms and signs of kidney and bladder stones

So, with a motionless stone (as a rule, it is single and large), we can freely not even guess about its presence. In any case, the signs of his presence are almost always weak, rarely appear and do not cause concern. Such a stone is often discovered by chance, with an ultrasound or X-ray examination of the kidney area about other patient complaints. Undoubtedly, a "quiet" stone feels more pleasant than small and mobile neoplasms. However, it only feels like it.

As we just said, it is slowly but steadily growing throughout the entire time we live with it. At one point, it will block the exit of urine from the kidney into the ureter, and this is inevitable. When this happens, you can't guess either. But this can happen in any circumstance. Including a picnic far out of town. Or on the seaside, where the nearest hospital is tens of kilometers away ...

The fact is that excreted urine will quickly begin to accumulate in the kidney. This will cause acute pain, rapid development of renal failure. Especially in such cases, those who do not have everything, so to speak, smoothly with the second kidney, are unlucky. For example, if it also has a stone or stones, inflammation, other disruptions in work.

If the second kidney is healthy, the patient's prognosis for acute blockage is not so bad. In particular, he will have enough time to get to the hospital. And the kidney will probably be saved. But if there are also problems with the paired kidney, an increase in the load on it due to the refusal of the "neighbor" will lead to an equally rapid cessation of urination in general. Then the patient will have no more than a day for all procedures - no more than a day to restore the functioning of the excretory system or undergo at least one dialysis procedure. For more than 24 hours, poisoning the body with nitrogenous decay products will not give it.

So "quiet" stones are good only if we, so to speak, breathe unevenly for any surprises, including unpleasant and life-threatening ones. Depending on the type of stone, the degree of its mobility and size, we will suffer more and more often or weaker and less often. For example, phosphate stones have a smooth surface, while urates and oxalates, on the contrary, are uneven, often covered with thorns. As we understand, the sensations when some and other stones come out will also differ greatly ... Sand gives the least pronounced colic, although it is also unpleasant, as it feels. In addition, sand of any type irritates the urinary tract no less than stones.

In a word, a characteristic sign of urolithiasis is renal colic. She touches every time a stone is displaced or tries to leave the kidney. Naturally, the ureter, through which the "unformatted" object passes, undergoes multiple spasms. Colic pain is acute, cramping, shooting. It is often confused with manifestations lumbar osteochondrosis... However, they can be distinguished by their results. Indeed, after several days of bouts of pain, the stone will probably either come out or get stuck. In the first case, we will see him, in the second, we will get on the operating table, which will also be very noticeable.

During the period of such an aggravation, sand is usually released after the stone. It forms a hard, visible sediment in the urine - if defended, of course. The accompanying trauma and irritation cause inflammation. More precisely, as a rule, exacerbation of an already existing inflammation urinary tract and its extension to other areas. Therefore, the release of stone and sand is often accompanied by cold sweat, pallor of the skin and other signs pain shock in combination with renal failure. But in the next few days, the patient's body temperature rises, and a febrile state may occur.

As already mentioned, sand, as a rule, is combined with stones, but it can also be present separately - especially in the initial stages of the disease. In any case, one does not exclude the other here, but rather complements. Both the release of the stone and the separation of sand are accompanied by signs of inflammation and irritation of the urinary tract. Even if the colic is over, we will continue to feel a burning sensation and a dull aching pain when urinating. Since trauma to the tissues of the kidney itself, as well as the mucous membranes of the urinary tract, is accompanied by inflammation, a high content of leukocytes, a significant admixture of blood, is often found in the urine of a patient with urolithiasis.

Thus, small stones and sand, of course, are much more painful in the current than stones that are solitary and inactive. However, the long-term consequences of the formation of both large and small stones are the same. With urolithiasis, the kidney and / or ureters, bladder, urethra inevitably undergo regular, more or less serious damage... Meanwhile, it is clear that the urinary system is in close contact with the external environment, which is already full of pathogens of various pathologies. In addition, she has a slightly more mediated, but also quite real connection (simply by location) with the reproductive system.

For the external genital organs, the presence of their own microflora on their skin is a prerequisite. And even normally, not all of this microflora is so harmless to other tissues. Injuries to the mucous membranes of the urinary system are fraught with the fact that they, in fact, "open the gate" for the spread of pathogens to its tissues. Moreover, the tissues are no longer external (the mucous membrane, if it is intact, can cope with the problem), but on the deeper ones. The urinary system, under normal conditions, has its own defense mechanism against external invasions. It is based on urine.

First, her normal environment- slightly acidic, and not all pathogens survive in such environments.

Secondly, its current has the opposite direction to the spread of infection, in order to physically flush the bodies of the pathogen back out. But in the case of inflammation (so far traumatic - aseptic) of the urinary tract, the balance of this fluid easily shifts to the alkaline side. This effect gives increased content there are proteins in it - they disintegrate right in the urine, causing the reaction of its alkalization. And the alkaline environment, as we understand, promises to the pathogen much more comfortable conditions for reproduction. Therefore, secondary infection with urolithiasis is a very common phenomenon. And even without her ...

Inflammation is inflammation, be it infectious or aseptic. If its focus has arisen in one part unified system, we can be sure that it will quickly spread above and below it. Therefore, even if the stones initially did not arise in the kidneys, but in the bladder, after the onset of cystitis, nephritis for us becomes only a matter of time.

Causes of Kidney and Bladder Stones

The easiest way to identify them is by the composition of the stones. It all depends on their type. It is not always possible to independently distinguish one stone from another - at least one episode at a time. For several, this can be done more accurately. As mentioned above, the urates that occur with gout are brick or blood red in color. However, sometimes there are also yellow urats. One way or another, the range of their colors is limited to shades of red, and this applies to both stones and sand. Another characteristic only for urates is the ability of several separate stones to merge, forming something like a bunch of grapes. In addition, we recall that gout has other symptoms - from the side of the joints.

Phosphate stones are also smooth, light gray or even white. Their distinctive feature- the ability to easily crumble after drying. Oxalates are also easy to recognize - their surface is bumpy, rough, sometimes covered with visible growths. They do not look like an anti-tank "hedgehog", but their progress along the urinary tract is not very happy either. Their color is brown or gray; in appearance, oxalates resemble pieces of ordinary rubble.

Precisely because oxalates more than other stones injure all the tissues with which they come in contact, their formation is accompanied by the most pronounced inflammations. Therefore, they often quickly become overgrown with phosphorus deposits, forming a mixed oxalate-phosphate stone. The reason for the pattern is simple: phosphate stones more often and more readily than others are formed precisely at the site of inflammation - where the balance of urine is already strongly shifted to the alkaline side. They are a direct product of the alkalinization reaction. That is why phosphate layers are found in the overwhelming majority of stones, except, perhaps, urates. Phosphate inclusions are equally often found both in oxalates and in calcium, organic stones.

When it comes to organic stones, it is usually the organic base itself that forms the core. It can be bacteria, blood proteins, sometimes - even helminths and their larvae, etc. And around this foreign object a capsule of solid salts grows.

In most cases, organic stones are phosphate-like in appearance - just with an organic core. But they can also contain layers - calcium inclusions, for example. So organic stones have no signs of their own - they always look like the stone they were overgrown with. Cholesterol stones form in the gallbladder and are made up of bile. Therefore, they are dark - black, dark brown, reminiscent of caked feces. They cannot be called soft to the touch, but they still have a special texture - as if not stone. Cholesterol stones are very often formed with the participation of calcium salts.

As we just said, the most common stones are phosphates and mixed ones. They are found in more than half of all cases of urolithiasis. And they arise where inflammation occurs - subtle, chronic. In general, the inflammatory process is the optimal and most common condition for the appearance of any stones, in any organ. This applies to the liver, and to the gallbladder, and to the salivary glands, and to the sinuses ... Actually, the same is the relationship between periodontal disease and tartar.

These two factors (inflammation and stone) are always mutually dependent. Septic or aseptic inflammation changes the local environment and creates unnecessary elements in it, triggering the growth of the stone. And from that moment on, the stone itself begins to irritate the surrounding tissues, supporting and developing causative inflammation. The only exceptions are two of the many cases. Namely oxalates and urates. The inflammatory process cannot become the root cause of their appearance - it can only be a metabolic disorder. So the inflammation they cause is always secondary.

The second important moment in the development of urolithiasis can be, oddly enough, our gender. Above, we have already mentioned in passing that women are more prone to urolithiasis and cholelithiasis. In particular, to the appearance of stones based on calcium and cholesterol. At the same time, they are more likely to get sick with osteoporosis - especially after menopause. The reasons for this difference are easy to guess: calcium metabolism and its intensity directly depend on how much the whole body considers important maintenance bones in good condition. And on how important their growth is to him, development, renewal.

The weaker sex is weak in only one sense - in the sense physical development, and even then not always. Anyway, female body initially "adjusted" to less resistance to physical stress than male. If desired, this is easy to fix, but nature itself has provided for everything just like that. And therefore there can be only one field for the active consumption of calcium with cholesterol in the body of an adult woman. Namely, both of these elements are required by her body in huge quantities during pregnancy. But we see where the catch is, right? Yes, it is that pregnancy is a periodical condition, and life is permanent.

Women with several children suffer from cholelithiasis and urolithiasis more often and more severely than childless or limited to one child. And this is due to the fact that in the body of a mother with many children, sharp fluctuations in the rate of calcium metabolism took place several times. Simply put, her body had already taken into account that the situation could repeat itself, and took appropriate measures. During periods when pregnancy does not occur, he seeks to store substances that he does not need yet. And as we understand, there is no separate storage for them, unlike carbohydrates, in the body.

In general, gender significantly affects the incidence of stones and the specifics of the course of this pathology. Well, the third reason for its development is often the peculiarities of our diet. What is metabolism in essence? This is a chain chemical reactions on the transformation of some substances into others. Moreover, at different stages, each reaction proceeds with the participation of a third substance, a catalyst. And the catalysts, of course, change depending on what was formed in the previous stage of conversion. Even if we do not know chemistry at all, we must understand: the same set of substances always takes part in each reaction. In some cases, their proportion is no less important than the very fact of the presence of all substances in the "set". In other words, if the body does not have any substances for the reaction or their proportion is changed, the reaction will either not happen or it will happen with an error.

All this leads us to the fact that normal metabolism and good nutrition are not just interconnected - one does not exist without the other, cannot exist. And yet we know so little about this that we take it for granted and even useful to break this rule every day.

For example, who among us does not know that strain C strengthens antiviral immunity? In general, to some extent this is true. But far from what we used to think. Vitamin C is no more useful in this matter than any other. Moreover: if we eat only it, we will get nothing except stomach or intestinal ulcers. Indeed, vitamin C needs so much to effectively convert that we cannot even imagine ...

Another option from a series of "everyday delusions" is special power systems. As we know ourselves, even if they are not a tape, they completely contain some restrictions. Actually, these restrictions make them special. Vegetarianism requires the elimination of animal products from the diet. In fact, raw food is quickly turning into almost vegetarianism, since we, people who are far from the Stone Age, simply taste unpleasant raw meat... In addition, raw meat makes it difficult for most stomachs to digest. In a word, it is not surprising that with the transition to this system, people quickly lose weight. They just start eating less and less, because you don't eat a lot of raw food - you don't want to ...

The same is the case with separate meals, meals according to blood group, calories, etc. In essence, they all create a more or less strict, more or less definite system of restrictions on certain foods, their quantity, and their combination. In addition to such "whole" systems, we often encounter individual bans - on coffee, chocolate, tea, confectionery, etc., etc.

It is usually simply impossible to understand the meaning of all these recommendations - they are meaningless by definition, initially. No matter what well-known "harmful" product we take, in fact it will necessarily be found that it is simply necessary for others, and the harm from its use has nothing to do with it. However, how proud we are of ourselves when we find the strength to refuse a cup of coffee, a cigarette, or a piece of chocolate! ..

There are a myriad of myths about the benefits and dangers of various foods, how they are cooked and our eating habits in society. And none of them is the absolute truth - the truth that benefits everyone. That is, someone may not need to drink coffee - if we already have angina pectoris or had a heart attack, this is perhaps really not the best idea. But if we were born with a slight deviation towards a slowdown in metabolic processes, without coffee, we will constantly gain weight and "sleep on the go." By the way, it will never lead us to a heart attack at all - even though we will drink it in liters.

Yes, there are many myths, but the truth alone does not change from their number. And it consists in the fact that each component of the product. which seems edible to us, for sure has nutritional value. That is, it takes part in chemical exchange reactions. From the point of view of the organism, there is no place for exceptions. Rather, there is, -to they all relate to products that seem inedible to us. And the blame for the intermediate options (which do not represent the nutritional value of a “fake” for a real product) lies entirely with us - with the civilization of which we are a part.

We have undoubtedly oversimplified this reasoning. We forgot to mention a lot of cases when someone is really forbidden to do something. For example, like coffee for heart problems. Likewise, no one would recommend products containing oxalic acid to a patient with oxalate stones - that would be sheer madness. Moreover, we have forgotten about the whole array of cases when the least accustomed of us to deny our appetite are gaining excess weight, too, at a record speed. And this habit is healthier to satisfy hunger immediately and completely for some reason does not make them.

All these particulars are also a kind of truth. But it is peculiar because it does not concern everyone, but only a few, for which, as they say, it just so happened. As long as our heart, stomach, kidneys, and other organs are healthy, there is no reason for us to think about what we will eat when they get sick. While we are healthy, we think about how to maintain this health - and even then not always, is it? And in moments of such reflections, it comes to our mind for some reason not to bring what we consider tasty to a balance with what is undoubtedly useful ... useful. And this part is wrong here - the course of our thoughts, our idea of ​​the laws of correct and unhealthy nutrition.

Let's say right away and honestly: lovers of a vegetarian diet and diets with varying degrees of severity of restrictions get sick with stones in certain organs much more often who eat well. But at the same time, one should not forget what exactly is full, and not every time with the same set of products, only cooked in different ways. No specific product leads to the appearance of stones. None, except consumed in quantities that exceed any needs and capabilities of the body.

By our will, this often happens with cholesterol and proteins. Phosphorus usually enters the body against it (which means that the question of its balance with calcium arises) and other inorganic compounds. The latter happens if we live in a region where the soil and / or water contains an abnormally large amount of elements that can disrupt metabolism or become the basis for the growth of a stone. By the way, if the topic has already piqued our curiosity, it will be useful for us to know that it is not always limited to the question of how hard or soft the water flows through the pipes from which we drink water. The development of urolithiasis is quite often caused by elements that are simply atypical - radioactive, which have become the product of unsuccessful chemical iecKoro synthesis (entering into the wrong reactions), obtained by nanotechnology.

In addition to inflammations of various etiologies and characteristics of our diet, the proportion between the consumption and consumption of various substances plays an important role in the development of urolithiasis. The proportion that remains with us throughout most of our lives. As we understand it, everything that has entered the body must be spent by it for biological needs. And not all these needs appear for him by themselves, without our participation. We've probably heard before that the secret of the rapid spread of diabetes and obesity in the world lies not only in the ability of diabetes to be fixed at the gene level. Obesity is definitely not fixed in the DNA, and the number of patients with it is also steadily growing.

Yes, in our time diabetes mellitus is not treated, but compensated with great success. Until injectable insulin existed, patients with this diagnosis more often died before having offspring and, therefore, passing on their pathology to children. Now, dying from diabetes still needs to be contrived ... And this, of course, affects the growth in the number of patients with congenital diabetes mellitus not for the better.

However, there is another relationship - excess weight also leads to the development of glucose metabolism disorders, since the cells of adipose tissue produce substances that inhibit insulin. And there are more and more fat people on the planet. Actually, against this background, all the above methods of maintaining the norm of weight grow like mushrooms after rain.

There is a relationship between diabetes and obesity - this is already a scientifically proven fact. It remains to be seen where obesity comes from in our world. Of course, we ourselves can guess - the word "hypodynamia" has long become for us as familiar as "salt deposition". This relationship was also explained to us more than a dozen times. As mentioned above, the body spends everything that gets into it for biological needs. And what, in essence, is this need? I mean, what needs he might have if he sits all day either in a work chair, or at home, or sleeps in bed? Indeed, only the most necessary - thinking, the nominal blood flow rate, the rudiments of coordination of movements ...

The human body, from a biological point of view, is designed not only for thinking, but also for physical activity. Only one type of activity, whichever one we choose, is not the optimal pastime for him. To correctly determine his needs and the work of all systems that satisfy them, it is absolutely necessary for him to alternate physical activity with mental.

The entire metabolic rate depends on the level of our activity - at any stage, whichever of the substances you take. When we run, as well as when we are nervous, our pulse quickens, the body temperature rises, and muscle tone increases. And the difference between these two states is that under stress, the brain orders the metabolic system to speed up its work, since it does not know how circumstances will turn in the next moment. But since most of the stress of our life physical actions does not concern, we will assume that the nervous acceleration of metabolism - this voltage is almost "idle".

The main consumers of most of the body's substances are the brain and muscles. The first is because it is his orders that all organs of the body obey, and it is simply impossible to overestimate its uninterrupted, correct work. And the second - because there are most of the tissues of this type in the body in a direct, quantitative ratio. And if we compare the volumes in which nutrients are consumed by the cerebral cortex and developed muscles, in any case, the palm will have to be given to the muscles. Again, because there are much more of them, and their needs during active work are much higher than those of the brain.

So, as we can see, the body has some needs regardless of whether we are sitting, running or lying down. Such is the need of the thyroid gland for iodine, of all organs and the cerebral cortex, for a certain minimum background of glucose in the blood ... But these needs for rest are greatly reduced. And the percentage of food that we eat every day, even on a normal diet, more than covers them - with a fair amount, which is deposited on our stomach, buttocks, torso or waist. The brain especially needs, in essence, only sugar and hormones that regulate the activity of the cortex. For the production of hormones, naturally, proteins are consumed, therefore, we will assume that it needs proteins, albeit indirectly.

But the muscles for work and recovery after it need all the proteins of the body, cholesterol, glucose, vitamins, hormones, high-quality blood supply. Because when the cortex is working even to its limit, its cells die infrequently, in very small numbers. Muscles working to their limit lose cells in thousands and millions. But they can afford not such a loss, since these neurons divide extremely rarely, in exceptional cases. Muscle cells, unlike nerve cells, divide at every opportunity, willingly, with a known percentage of growth - in place of one dead cell, 2-3 new ones necessarily appear.

It is possible to trace visually at what speed and with what success the muscle fiber increases in volume at any time, even by your own example, even by someone else's. If muscle didn’t grow, the sport of bodybuilding wouldn’t exist. But the brain does not increase in volume from work. And people with a large skull are not always smarter than others. Much more often it turns out that they, on the contrary, have a brain with less tissue volume than usual. And their large skull is explained by hydrocephalus (cerebrospinal fluid accumulates in the ventricles of the brain) or rickets transferred in childhood.

And all this leads to the fact that we can and must stimulate many needs of the body ourselves. And very many fundamentally important parts of metabolism will be regulated either by us, or, so to speak, by no one. After all, our brain, no matter how wide its capabilities, is by no means omnipotent. For example, above we had the opportunity to complain about the abundance of phosphates in our everyday life - an abundance, the appearance of which no one warned us. Is it about that. that phosphoric acid salts are an excellent substitute for fish, they say so often in the media? No. And we could well not even suspect about it. And since excess phosphorus spontaneously triggers the leaching of calcium from the bones, we need not be surprised at calcium stones in the kidneys and gallbladder.

Yes, as we age, our need for calcium decreases by itself, as bones stop growing. And an increase in the intake of phosphorus, it turns out, again increases this need. The brain, in the conditions in which we put it, made its decision. Its consequences were an increase in the fragility of bones and at the same time the appearance of stones where they did not belong. The question arises: could we consciously, using our own knowledge, take more constructive steps? The answer to it is yes, it is quite possible to turn a good half of the harm done to us by phosphates to our advantage. Moreover, in just a couple of months.

It is enough for us to only slightly stimulate the development of the musculoskeletal system. Let's say you start jogging in the morning, sign up for a pool or fitness club ... Moderate, strictly dosed loads on the skeleton and joints will trigger a strengthening response in them. This will at once create a field for the consumption of excess phosphorus, stop the process of calcium excretion. It is likely that age-related destruction of our teeth, and even more so the periosteum, will stop with them. In a word, what creates a noticeable and annoying for many people who are not yet old cosmetic defect... At the same time, this example well reflects the difference between the work of different parts of the brain. In this case, between the principles that his automatic regulatory system uses (it is called limbic) and what the cortex is capable of, if you set it a task deliberately ...

Thus, urolithiasis is, of course, a polyetiological disease. And this term means, in essence, that medicine cannot always say for sure where they came from and how we now get rid of this dubious joy. Not to the credit of medicine, it really often cannot accurately establish the cause or causes of many disorders. It's just that there is a reason to throw the same stone into our, so to speak, vegetable garden. This stone looks like this: medicine is confused in the reasons, when too many of them are found, and some of them are interconnected. The question arises: where did this personally in our life come from such a number of especially unfavorable circumstances? .. It is quite obvious that we have included the lion's share of the points in the list of reasons ourselves, with our own hand. And it is this fact that serves as the basis for considering our personal, and not someone's, mistakes as one of the most common, most influential factors in the development of this disease.

Treatment of kidney and bladder stones

As we saw above, simply balancing your diet so as not to grow the disease yourself is not so easy. It turned out that we, successful and modern people, often do not think about elementary things. In particular, over how much a full meal cooked at home weighs and what, with such a volume, is its true nutritional value. We rejoice at our appetite and excellent digestion at zero activity, not realizing that this is more an anomaly than a reason to be proud of ourselves. We are sure that for an omnivore a diet according to the principle “the more vegetables, the better” is ideal. And at the same time, we are afraid of completely natural, simple substances like caffeine or theanine like fire, fearing that they may be much more harmful.

Yes, we have enough difficult problems at work and in the family. And we are sure that if we add to them the counting of bread units, the dosage of portions, the schedule for taking supplements, they will take away our last joy. Namely, the ability to just eat what you want, in the amount you want. We sincerely want someone else, less busy and more intelligent, to take at least part of us for us. necessary decisions... And he saved our already overloaded crust from all these details ...

In general, the constant reminder of the need instead of wanting really spoils the appetite of many. But while we are talking about prevention, we don't have to follow these rules every day. It's just that in this case it is important not to turn the "respites" into a rule. The main thing for us is to find that form of maintaining nutritional balance, which, while prolonging our life, at the same time does not poison every moment of it.

The collection of strict rules is treatment - therapeutic measures aimed at eliminating or compensating for an already fully established pathology. And even having taken care of the state of our metabolism on time, even taking all measures in our power, we must understand that they do not guarantee us complete safety. Indeed, in addition to our own mistakes, there are also such "misunderstandings" as concomitant diseases, really very significant features and the circumstances of our life path. Sometimes their influence is so strong that even the most careful self-care cannot save him from it.

Much in our life looks more like an inevitability than a simple threat. We cannot cope with many facts of reality! ", And measures. This means that everyone has the prospect of getting sick, always, at any age. And it is quite probable that all the measures we have taken above will only partially compensate for the harm inflicted by life itself.

Medical treatment of kidney and bladder stones

That is why, in any case, it does not mark us to familiarize ourselves with the prospects and the onset of urolithiasis, and its treatment. I must say that, in general, we may not be particularly worried about this. Yes, once they died from her, and died often, a painful death. This happened after an acute blockage of the urinary tract or due to renal failure caused by a long stay of stones and sand in these organs. Now, timely, regular disposal of both (say, as they are formed) will allow us to live the same way as before. That is, without any particular inconvenience, although not without some damage to our comfort.

Regardless of what our stones are made of and what process led to their appearance, it is not difficult to remove them in modern conditions. It is much more difficult to prevent them from recurring. If we know about the risk of their occurrence (such factors are in the life of every person), it would be nice for us to show special consciousness. And make it a rule to undergo an ultrasound examination regularly, and not on special, rare cases when we are already completely unbearable. Ultrasound is not a safe method in all aspects, but in most of them. And he detects such neoplasms with very high accuracy - even if the stones are more like sand.

So, if there are at least two or three serious risk factors in our life, it will not hurt us to visit a urologist at least once a year. This is important because the earlier a new stone is identified, the easier it will be to remove it. And the less likely it is to suddenly start moving. As we remember, the idea of ​​leaving the body can, so to speak, visit a stone at any time, under the influence of a lot of factors. Everything would be fine, but this "journey" does not always go well, not with all sorts of stones. In addition, it is distinguished by pronounced soreness and complications on the organs, which are at the same time subject to injury.

Meanwhile, there are many ways of easier and safer removal of stones now. Currently, surgical intervention for urolithiasis is carried out in the rarest cases - neglected, complicated, when any other help has long been delayed. These are cases of rare persistence on the part of the patient. Cases where, by a strange coincidence, he either really did not notice the obvious, or ignored his problem with stoicism worthy of better use.

For example, a stone or stones are usually removed together with the kidney. This happens when a patient is admitted to the hospital with signs of renal failure and acute blockage. And during the examination, the doctor reveals one stone that is really stuck recently - the one that became the reason for going to the hospital. And the kidney, which has long turned into a shell of connective tissue, inside which, as if in a bag, there are only a few large stones and urine. In other words, in cases where one kidney has long been dysfunctional, since its filtering tissue (parenchyma) has been replaced by stones. But the patient managed not to notice the loss of one organ because the paired one worked for two for a long time. Not without interruptions and alarming symptoms but still worked.

Yes, if there is nothing left of the organ or part of the tissues of the urinary system that would make sense to preserve, the doctor will also not be able to offer anything other than an operation. When is the removal of the kidney, bladder, tissue part or ureters / urethra indicated? In essence, in the same, as elsewhere, when talking about any other organs.

Namely:

1. In the presence of foci of purulent decay and necrosis, which can be both malignant and result from infection.
2. If there are signs of a malignant process in the tissues. In the case of the kidney, it will be removed completely, regardless of the location of the tumor. Including if not she herself, but her adrenal gland underwent a rebirth.
3. In the presence of benign neoplasms or unclear etiology, but large enough to be considered a mechanical obstacle.
4. In the event that very serious injuries were caused to the tissues during the release of the stone.

As a rule, only one of the two kidneys must be removed unambiguously. But it is no secret that a long-term lack of improvement in the course of urolithiasis or its complications gradually lead to degeneration of both kidneys. It's just that the rate at which they fail is usually not the same. However, here you’re lucky ... In any case, if one kidney is preserved and functional, the other does not need to be prosthetic. However, if there are signs of refusal in it, the patient is prescribed hemodialysis procedures - with a certain frequency, strictly according to the schedule. Dialysis and an artificial kidney are almost the same thing. Only the frequency of the same procedure is different. Hemodialysis as an auxiliary measure is carried out no more than 2 times a week, and an artificial kidney is the same dialysis, only every other day.

But parts such as the ureters, bladder, urethra are prosthetic after removal of a non-functional or severely damaged part. Sometimes good results are achieved by placing something like an indwelling catheter made of specially designed polymers. But the method of prosthetics is highly dependent on the volume of the removed tissue.

A catheter that is too large, no matter how well its material mimics the properties of living tissue, is usually undesirable, because its wearing quickly leads to complications. As a rule, constant inflammatory processes at the junction of its edge with the tissues of the urethra or ureter: And also to the deposition of salts on its walls, irritation of the surrounding tissues - including mechanical and chemical. That is why the option of restoring the patency of the urinary tract after the operation is their plastic with the participation of the body's own tissues taken from other areas.

If the wall of the bladder is under threat of removal, the situation becomes somewhat more complicated. In general, cases when the bladder is removed completely are not as rare as we would like. This can happen as a result of prolonged infectious cystitis, cholecystitis ( gallstones in the bladder), cystitis caused by bladder cancer or urolithiasis. In addition, some pathologies of the muscular or mucous layer of the bladder are congenital and even autoimmune.

So there are plenty of options here. The main difficulty is that the bladder is formed by muscle, not connective tissue. Meanwhile, not a single, even the most organic material for prosthetics has the main property muscle fiber- the ability to contract and relax. This is the problem with any indwelling catheters in the urethra and ureters. And for the same reason, doctors find it so difficult to find a complete replacement for their own tissues of the bladder. This organ is prosthetic, creating new department in the tissues of the rectum - usually in its ampoule. However, in the last few years, there has been an active development of a technology for laboratory cultivation of tissue, similar in its properties to the muscular wall of the bladder.

In the meantime, we did not live up to the indications for the operation, we will be offered to remove the stones in some less traumatic way. Currently, the medical rules adopted in the treatment of precisely urolithiasis prescribe the removal of all neoplasms with a diameter of more than 5 mm. Because, as it turned out experimentally, larger stones can sometimes come out on their own. However, this process is associated with increased risks and injuries and blockages.

Among the methods of "stimulating" stones; so to speak, the method of shock-wave crushing has gained the greatest popularity by the earliest possible release. We will not remember the scientific name of the method right away, since it sounds like “extracorporeal shock wave lithotripsy”. Medicine has not yet figured out all the long-term consequences of its periodic use (with relapses of urolithiasis). But as a one-time measure, it is definitely safe and not at all traumatic.

The essence of the method is simple: a device that emits sound waves of various frequencies is directed to a stone located anywhere in the urinary tract, including the kidneys. For stones with different composition waves of different ranges are used. There are not so many stones in the world that are resistant to all ranges. Most often, gallstones show such resistance. From others, more or less small fragments, and sometimes even sand, remain. Then these fragments leave for several days by themselves, with a stream of urine. If there are good reasons, the doctor can, at his discretion, put the patient in the hospital for the period of the release of the sand - in order to observe the process. But if the situation is not complicated by anything, after the operation the patient is often discharged, providing detailed recommendations what to do in the coming days.

Of course, the possible complications from this procedure are exactly the same as the list of complications from an independent stone exit. The shard can sometimes be too large or sharp. And somewhere along the urinary tract, there are often mechanical obstacles - scars and strictures from past episodes, tumors, adenoma in men, edema due to inflammation. Naturally, they cannot be called a reason for the operation, and they can create serious troubles. It is in such cases that the patient is shown constant observation until the release of all fragments.

If there is a blockage, we will again go to the surgical department, but, again, not to remove the kidney - do not worry ahead of time. For all cases when this same lithotripsy did not meet the expectations of the doctor, there are special preparations designed for the chemical splitting of stones. This type of procedure is called a percutaneous nephrostomy. With it, you still have to make an incision - a small one, sufficient to install something similar to a dropper or a shunt. A solution that is effective against this type of stone is subsequently fed through this shunt. In addition, with its help it is very convenient to rinse the target area directly with antibiotic solutions - for example, to eliminate sepsis or aseptic inflammation after stone irritation.

Whether it is worth treating urolithiasis with some other methods, except for their removal followed by anti-inflammatory therapy, is a good question. As mentioned above, stones are most often caused by inflammation. And the already formed stone itself begins to irritate the surrounding tissues, supporting and intensifying the initial inflammatory process. In other words, if we have so far only inflammation, stones or sand, we should expect in the near future, for good reason. And all attempts to relieve inflammation, when the stone has already arisen, and does not intend to move from its place, are doomed to failure in advance.

Here is such a pattern ... In urology, it is generally accepted that single and small stones that have arisen for the first time can come out on their own if they are helped a little. In particular, conduct a course of antibiotic therapy to suppress sepsis. And at the same time a short course sedatives or antispasmodics. Together, they will noticeably expand the inner space of the urinary ducts and give the stone a chance to leave the body in the near future. Therefore, in itself, conservative therapy of urolithiasis exists and is applied separately from attempts to directly influence the stones. It's just that most cases do not allow its use separately and requires an integrated approach.

Alternative treatment for kidney and bladder stones

In this regard, it is most appropriate for us to believe that removing stones without the help of a doctor or by other means, other than surgical ones, is pure water madness. It will be good if we do not say goodbye to certain parts of the urinary system. Parts for which we will have a reason to cry, and more than one ... We must remember that a stone is a fairly dense and chemically stable neoplasm. That is, it is enough for such harmless means as herbal teas or mineral water to somehow affect it.

Yes, water with a certain acid-base balance (acidic or alkaline) helps to slow down the formation of new stones of the corresponding type. But for this it is necessary that the main reason for their appearance is a local or general violation. That is, either urine oxidation as a result of a malfunction in the metabolic system of some acids (urinary, oxalic), or a local imbalance of the media. Let's say alkalinization of urine due to local inflammation. If our stones are not explained by any of these mechanisms, drink mineral water or not is a matter of personal taste. This will hardly affect the course of pathology anyway.

Mineral water with any balance and composition does not have the ability to reduce or completely dissolve already formed stones - not by a millimeter, no matter how much we drink it. This is a myth, another amateur interpretation. She tries to explain the cases when the doctor prescribes this or that mineral water to the patient, omitting the comments why he made such a decision. It is in the place of comments that were not provided by a specialist, and free interpretations of this kind appear.

Let us repeat: legends about the alleged omnipotence of funds from the "natural pharmacy" now abound. But the fact remains: at a time when only such means were at the disposal of medicine, urolithiasis, cholelithiasis, gout, diabetes mellitus were considered and were fatal diseases. Without the ability to forcibly remove the stone and extinguish the infectious inflammation in the urinary tract, medicine of the past could give its patients a prognosis only for the coming months, and no further.

All that herbs, heating and other measures of traditional medicine can do is to somewhat facilitate the passage of the stone and significantly reduce inflammation. But the latter applies only and exclusively to aseptic inflammations. That is, caused by a single stone injury, without the addition of an infection. It is possible to destroy a stone that is too large only with special means, and to extinguish the infection only with antibiotics. There have never been any options here. Everything else will do only for prophylaxis and during the recovery period after removing stones. But to remove them and to get rid of colic, nothing else will wait for us.

If the natural boundaries of the effectiveness of unconventional means are clear to us, we will analyze what it will be useful for us to apply as a conservative therapy. That is, against small or single stones, as well as after removing large stones.

Let's start with the simplest:

1. If an attack of colic took us by surprise (this always happens, with rare exceptions) or it is very strong, we'd better take some kind of antispasmodic. For example, "No-shpa" will do or, if we have the skill, we can make an intramuscular injection of 5 ml of baralgin solution.
2. Spasm usually depends on the intensity of pain as much as on the strength of contraction of the muscles of the ureter, urethra, etc. Therefore, to relieve pain, you can take any of the available, non-specialized painkillers - "Ibu-profen", "Solpadein", "Ketanov", etc. ...
3. If we have urinary retention, we may be doing ourselves a disservice by overdoing medication. In this case, it is wiser to try to influence the pain and spasm with a hot heating pad - on the kidney area, from the back, for no more than 20 minutes.
4. With renal colic without urinary retention, the liquid should be drunk generously, seeking to increase its separation. Perhaps a more intense current will help remove the stone. If there is a complete blockage of the urinary duct (urine is emitted poorly, swelling of the legs has begun, "bags" under the eyes and aching pain in the kidneys appear), it is better, on the contrary, not to drink water. In any case, you shouldn't drink more than 1 glass of it per hour.
5. After discovering phosphate stones, we need to switch to a diet that is exactly the opposite of a vegetarian one. And limit vegetables - especially fresh ones. Our task from now on and for life is to maintain the acidic balance of urine, since its alkaline environment contributes to their recurrence and accelerates growth. The easiest way to do this is to start drinking juices and other sour drinks after each meal. For example, fruit drinks, citrus juices, a solution of 2 tbsp. tablespoons of vinegar (preferably homemade or quality) in 1 glass of warm water.
6. If we have had an oxalate episode, we should eliminate foods high in oxalic acid from our diet once and for all. Usually all foods and drinks with a sour taste contain it in certain quantities, including sour berries, citrus fruits, etc. In a word, oxalic acid is contained in more than one sorrel, and this must be remembered. Traditionally, the list of “non grata products” includes sorrel, spinach, parsley, dill, asparagus, and cilantro. As well as red and black mountain ash, rose hips, lingonberries, blueberries, all citrus fruits. It will be nice if we start treating food acids more carefully - we will also give up carbonated products and, in general, any products where the article "acidity regulators" appears. In fact, this is food acids... Now we have problems with assimilation on the idea of ​​only one of them. But practice shows that such an metabolic disorder affects not one, but several similar or identical reactions.
7. In the presence of calcium stones or [inclusions of this kind in other types of stones, we should stop the leaching of calcium from the castes. As mentioned above, for a start, it will be good for us to stimulate its complete assimilation of the bone - for example, by strengthening the skeleton with the help of sports. Then it will be very good if we limit the intake of phosphates in the body - from food in which they are present as a dietary supplement. As a rule, these are all foaming drinks, whipped products (marshmallows, mousses), meat and sausages.

It must be remembered that food products by themselves never provoke the leaching of calcium from the bones - for this they need suitable conditions like sedentary image life and excess phosphorus. But given these conditions, individual products can indeed speed up this process.

In other words, if, as usual, we stubbornly avoid activity, believing this measure to be too difficult, we need to know what else to avoid so as not to worsen the situation. Foods that accelerate the leaching of calcium or contain high amounts of it include coffee (especially instant), legumes, chocolate, milk, and all dairy products. As well as whole grains of wheat, corn and oats.

Finally, the third thing we will have to do is to rinse the laundry more thoroughly after washing, to limit the intake of fish. Of course, it will be very successful if we get used to washing dishes, floors, etc. in protective gloves. Or at least partially switch to phosphate-free personal and household hygiene products.

As for organic, cholesterol stones and urates, in this section we have nothing to say about them. We will discuss urates and cholesterol stones in detail later, when talking about the pathologies associated with them. And organic stones are a problem so large-scale or, on the contrary, arisen by chance, that it certainly cannot be solved by simple changes in our habits. Protein in urine is caused by large-scale blood disorders or kidney failure. Organic stones are very serious. Whatever it was, recommendations for their elimination can only be given to us by a doctor, and no one else. So we'd better not discuss this topic on our own and don't try to correct it - most attempts of this kind end quickly and badly.

A more difficult question is the restoration of work and the state of the urinary tract after the "crisis". Recall that stones arise not only in the kidneys and not only due to metabolic disorders, sepsis ... Often the reason for everything is another mechanical obstacle in the path of urine flow - a benign or malignant tumor of the tissues that form them. Or, in general, a tumor of an organ adjacent to the urinary tract.

In women, such an obstacle is most often a neoplasm in the rectum or uterus, and in men - prostate adenoma. In both sexes, internal hernias and pelvic tissue tumors can have the same effect. And also a phenomenon called kidney prolapse or mobile kidney. With it, the kidney gets the opportunity to shift depending on the movements of the body. It becomes mobile due to congenital or acquired disorders of the structure of the bag of connective and adipose tissue, which keeps and protects it normally. How one can be born with such a defect is understandable - for many reasons, for which either the mother or an unfortunate coincidence of circumstances will be to blame. And it is easy to get an anomaly in adulthood with an injury to muscles or ligaments (especially the back). Or with excessive weight loss, which is likely to cause a critical decrease in the fat layer in the kidney bag, making it seem too loose.

In any scenario of the prolapse of the kidney, the ureter leading to it often changes its position, loops appear on it. Under other circumstances, it is even capable of twisting. And all this, of course, greatly disrupts the rate of urine outflow from the mobile kidney, quickly leads to the development of secondary inflammation in it and the ureter itself. We remind of this because without a doctor we cannot distinguish a blockage with a stone from a blockage by something else. But if this is not a stone, all our efforts will turn out to be useless at best, and even deadly at worst (if the tumor is malignant).

Well, if the presence of stones in our country has already been confirmed and proven, we will deal with the elimination of the prospects for their growth, stuck and, most importantly, relapse. As mentioned, it would be nice for us to make sure that there is no urinary tract infection. After all, the inflammation caused by the pathogen will not remove any remedy, except for the antibiotic, intended to fight precisely:;: this pathogen. But the inflammation of traumatic etiology may well be fought by a number of individual plants and collections from them.

Naturally, the location of the target process simply obliges us to opt for broths and other liquid forms of funds. Compresses and other methods of affecting the skin are not helping us here, except that the only thing we want to act with is warmth. The fact is that the entire urinary tract is located deep within the pelvic tissue. The kidneys are located relatively close to the surface of the back, just below the lower back. However, as we have just said, they are reliably protected and even isolated from outside influences by a rather thick layer of fat lining their capsule from the inside. And in sum, this gives us the almost complete futility of trying to apply compresses to them, etc. The result - taking funds in liquid form will be much more effective.

So, here are several recipes for decoctions used in the treatment of urolithiasis:

1. Take 2 tbsp. tablespoons of crushed dry birch leaves, white and 1 tbsp. a spoonful of buds of the same tree, add on the tip of a knife baking soda... Mix everything, put it in a thermos, fill in "/ 2 cups of boiling water, close the lid and leave for 1 hour. Then strain and take 1/2 cup 3-4 times a day just before meals.
2. Take in the same amount, dry, crushed, the color of cornflower, licorice root and bearberry leaf. We mix everything, take 1 tbsp. a spoonful of the mixture, put in a thermos. Pour the mixture with 1 glass of boiling water, leave for 15-20 minutes and strain. Let's start taking an infusion of 1 tbsp. spoon three times a day before meals.
3. Take 1 tbsp. a spoonful of dry chopped St. John's wort, put in an enamel bowl, pour 1 glass of boiling water. We put the dishes on low heat, let them boil. Cover and cook for 10 minutes. Then remove from heat, let cool and strain. The broth should be taken in glasses 3 times a day before meals.
4. Take washed, dry, chopped 2 tbsp. tablespoons of marsh wheatgrass root, place in an enamel or glass dish, pour 1 glass of cold water. Cover with a lid and leave to infuse for 12 hours. Then pour this water into a separate bowl and fill the roots again with 1 glass of boiling water. Leave the second infusion for 10 minutes, strain it. Combine both infusions (cold and hot), we will take a mixture of 1/2 cup three times a day before meals.

Of course, if we are counting on an independent release of the stone, we can resort to diuretics. There are also many such plants in the world. However, before we start taking diuretics, we definitely need to make sure that we do not have a serious difficulty or an interruption in the flow of urine. Otherwise, their reception will not lead to anything good.

1. Take 1 tbsp. a spoonful of dry crushed cloudberry leaf, put in a thermos, pour 1 glass of boiling water. Leave to infuse for half an hour, then strain. You need to take the infusion for 1/4 cup 3 times a day after meals until an obvious increase in the urge to urinate.
2. Take 1 tbsp. a spoonful of fresh or dry knotweed herb (knotweed), cut with a sharp knife, place in an enamel bowl. Pour 1 glass of boiling water, put on low heat, let it boil, leave for 10 minutes. Then remove from heat, let cool and strain. The broth should be taken in 1/4 cup 1 time per hour until the urge to urinate increases.
3. Take dry, crushed, equal parts bearberry leaf, yarrow herb and knotweed grass. Then add half the volume of the herb of the string of any of the herbs already harvested. Mix everything, place in a thermos, pour 1 glass of boiling water and leave for half an hour. Then we will strain and take 1/2 cup 1 time in 2 hours until the urge increases.
4. Let's take equally, dry grass of a field horsetail, fruits of a juniper and Birch buds... Mix everything, place in a thermos, pour 1 glass of boiling water and close with a lid. Let it brew for half an hour, strain. We begin to take an infusion of P2 glasses 3 times a day after meals until the urge to urinate increases.

www.sweli.ru

Bladder stones - symptoms and treatment

• Decoding of analyzes online - urine, blood, general and biochemical.
• What do bacteria and inclusions mean in urinalysis?
• How to understand the analysis in a child?

• Features of the MRI analysis
• Special analyzes, ECG and ultrasound
• Pregnancy rates and deviation values.

Decoding analyzes

Bladder stones (cystoliths) form when minerals coalesce into small, solid formations. Suitable conditions occur with incomplete emptying of the bladder, due to which the urine becomes concentrated - this leads to the crystallization of the dissolved minerals it contains.

Sometimes these stones come out (while they are small), sometimes they are fixed to the wall of the urinary or urethra, gradually increasing in size.

Cystoliths often remain in the bladder for a long time without causing any symptoms and are discovered by chance when undergoing examination for other health problems.

Causes of Bladder Stones

Since cystoliths begin to form in residual urine, which is not completely excreted from the bladder, the search for the causes of stone formation is associated with certain diseases that interfere with complete emptying. These pathologies include:

• Neurogenic bladder - occurs when the nerves connecting the bladder to the spinal cord and brain are damaged (for example, after a stroke or spinal injury).
• Enlarged prostate - enlarged prostate compresses the urethra.
• Medical devices - catheters, sutures, stents, third-party bodies in the bladder, contraceptive devices.
• Inflammation of the bladder.
• Kidney stones - These can migrate through the ureters into the bladder and grow in size.
• Diverticula of the bladder - urine accumulates and stagnates in them.
• Cystocele - In women, the wall of the bladder may prolapse into the vagina, interfering with emptying.

Types and composition of stones

Not all stones are composed of the same mineral. Their various types include:

• Calcium stones - composed of calcium oxalates, phosphates and hydroxyphosphates.
• Uric acid stones are the most common type in adults.
• Struvite - This type of stone is most commonly found in women with urinary tract infections.
• Cystines - occur in patients suffering from a hereditary disease of cystinuria, in which the amino acid cystine passes from the kidneys into the urine.

Cystolites have various sizes and textures - they can be single or arranged in groups, have a rounded shape or have outgrowths.

The largest stone found in the bladder weighed 1899 g and measured 17.9 x 12.7 x 9.5 cm.

Bladder stones symptoms

Sometimes the symptoms of bladder stones do not appear for a long time. But, as soon as they begin to irritate the walls, characteristic signs appear. So, the symptoms of a stone in the bladder can be as follows:

• Penile discomfort or pain in men.
• More frequent urination or intermittent flow of urine.
• Slow onset of urination.
• Pain in the lower abdomen.
• Pain and discomfort while urinating.
• Blood in the urine.
• Cloudy or abnormally dark urine.

Features in women

The reason for the formation of cystoliths in women can be cystocele (urinary prolapse in the vagina), contraceptives that migrated into the bladder, vaginal reconstruction surgery.

Cystocele is manifested by the sensation of a foreign body in the vagina, discomfort during sex.

Because the urethra is shorter in women than in men, infectious inflammation (urethritis) is more likely to progress to cystitis (inflammation of the bladder). Recurrent cystitis is a risk factor for the formation of cystoliths and a sign of their presence in women.

Diagnostics

The presence of cystoliths is detected using the following methods:

• Urinalysis - the presence of blood, bacteria and mineral crystals is determined.
• CT scan.
• Ultrasound procedure.
• X-ray (with this examination, not all types of cystoliths can be seen).
• Intravenous pyelography - a special contrast is injected intravenously, which is secreted into the bladder through the kidneys.

Bladder stones treatment

With small stones, increased water intake contributes to their natural excretion. If they are too large to pass through the urethra, treatment is divided into two groups: stone crushing and surgical removal.

It is important to note that there is no scientific evidence to support the effectiveness of treatment with folk remedies.

Crushing stones

Cystolitolapaxia (stone crushing) consists in inserting a thin tube with a camera at the end through the urethra into the bladder, with which the doctor sees the stones and can crush them.

For this, a laser, ultrasound or mechanical crushing is used, after which the debris is washed out or sucked out. This procedure is performed under local or general anesthesia.

Surgical removal

If the stones are so large that they cannot be crushed with cystolitolapaxy, surgery is another treatment option. The surgeon makes an incision in the abdominal wall and bladder through which the cystolite is removed.

Possible complications

Despite the fact that some cystolites do not cause any complaints, they can still lead to the development of a number of complications:

• Chronic bladder dysfunction (frequent urination, associated pain and discomfort). Over time, cystolitis can completely block the opening of the urethra, blocking the flow of urine from the bladder.
• Urinary tract infections.

Since the formation of stones, as a rule, is caused by the presence of some kind of disease, there are no reliable and specific methods of prevention.

However, if a person develops any disorders of the urinary tract (for example, pain when urinating, discoloration of urine), it is advisable to immediately seek medical help... Drinking enough fluids also helps dissolve minerals.

If a person has an infection of the urinary tract and an incomplete emptying of the bladder, they should try to urinate again 10-20 seconds after the first attempt. This technique is called "double voiding" and helps prevent cystoliths from forming.

It is believed that a sitting position while urinating helps empty the bladder completely in patients with an enlarged prostate. This, in turn, prevents or slows down the formation of cystoliths.

• Print

Urolithiasis is quite widespread throughout the world. It accounts for more than a third of all diseases of the urinary system.

Despite the fact that it is well studied, the mechanism of stone formation is known, the number of cases of the disease has not only not decreased, but, on the contrary, is steadily increasing.

The reason for this, in the opinion of most doctors, may be the deterioration of the environmental situation, an increase in the population's tendency to physical inactivity and improper, including excessive, nutrition.

What it is?

Urolithiasis is the presence of insoluble stones (calculi) in the urinary tract and in the kidneys themselves. The disease occurs more often in men, but obese women are also at risk of developing the disease.

Causes and mechanism of development

The process of calculus formation is influenced by a number of factors, the main of which are:

The root cause of the appearance of stones in the bladder is an important aspect. Before removing stones, doctors will often prescribe a course of therapy that eliminates the cause of the pathology (for example, they treat metabolic disorders, eliminate infectious diseases).

Classifications

Stones can be of various shapes and shades, consistency and chemical composition and also have multiple or single characters. Small stones are called microliths, large ones are called macroliths, and single stones are called solitary stones. There are several classifications and forms of the disease.

According to the types of stones, pathologies can be of the following forms:

Oxalate	when oxalic acid salts act as raw materials for stones, these stones have a rough surface and a brown color, they can scratch the mucous membrane, which causes soreness and stains urine in a reddish color.
Phosphate	when stones are formed from phosphoric acid salts, these are rather fragile calculi with a soft structure and a light gray tint. They usually appear as a result of metabolic disorders.
Protein	representing protein casts.
Uratny	formed on the basis of uric acid salts, these are smooth calculi that do not injure the mucous membranes, usually observed in residents of hot countries and occur against the background of gout or dehydration.

In addition, stones can be primary or secondary. With the primary formation of stone formation occurs against the background of stagnation of urine in the urinary cavity. In the secondary form of the disease, stones are formed in the kidneys, and they enter the bladder cavity through the ureter.

Symptoms of the presence of stones

In women, the symptoms of bladder stones are varied, but they cannot be called characteristic only of this disease. If the stone moves into the bladder and has not yet descended into it, then the symptoms of the disease appear in pains of varying strength. It can be pain in the lower abdomen suprapubic area, in men, pain can be given to the perineum and to the penis. It increases with urination, with a change in body position.

If a stone has formed in the bladder itself or has already safely descended into it through the ureter, then the symptoms will be different. Painful sensations are mild, aggravated by urination or during intercourse. It is possible to determine the presence of a stone at the moment it overlaps the orifice of the urethra. It can be a sign of interruption of the urine stream or its complete blockage.

Acute urinary retention can be replaced by urinary incontinence if the internal sphincter of the bladder does not close due to a stone overlapping it.

Diagnostics

With stones in the bladder, symptoms can be detected in varying degrees, however, in any case, they are the basis for a visit to the doctor. In the course of diagnostics, this assumption will be confirmed or refuted. The necessary research will determine not only the presence of a stone, but also its exact location, size, nature of the stone-forming substance, as well as the presence / absence of concomitant diseases, etc.

As a rule, in this case, the following are carried out:

• general urine analysis;
• general blood analysis;
• urine analysis for stone-forming function;
• X-ray examination;
• Ultrasound, etc.

If there are grounds to assume the presence of other diseases, additional studies and diagnostic measures may be prescribed, which ones, in each individual case, are determined by the attending physician. After receiving comprehensive information regarding this disease, the patient is assigned adequate treatment, in particular, it is determined in what way the stone is to be removed.

Possible complications

Even if the stone in the bladder does not cause any painful symptoms in the patient, which is not at all a rare situation, it must be removed due to possible complications... First of all, the patient is susceptible to blocking the outflow of urine at any time, the development of hydronephrosis or pyonephrosis, and even kidney damage.

Frequent inflammation of the urinary tract can lead to progressive kidney dysfunction and the development of arterial hypertension... The presence of calculi within the bladder can cause:

• constant irritation of its wall;
• the formation of abnormal structures, as well as cancer cells;
• violation of the contractility of the muscles of the bladder with the emergence of its so-called atony or, conversely, its excessive contractility.

The necessary treatment should be carried out immediately after the diagnosis is confirmed. It is impossible to delay the operation, as this can lead to kidney necrosis and ultimately to kidney failure.

How is stone crushing in the bladder?

Depending on the severity of the symptoms, one of the options for the treatment of bladder stones is selected:

1. Removal of calculus with a cystoscope. In this case, a special metal tube equipped with optics is inserted into the patient's urethra. An examination of the bladder and the orifice of the ureters is performed. Then a tube - a stent is inserted into the opening of the ureter, where the pathology is detected, which resumes the natural outflow of urine.
2. Conservative treatment. It is prescribed when the size of calculi is less than 3 millimeters. In this case, the patient is offered drug therapy and health food... The main goal of drug treatment is to dissolve stones and eliminate acute attack illness. To combat pain, drugs such as No-shpa, Baralgin, Papaverin, Spazmalgon are prescribed. Medicines are presented in a wide range in any pharmacy. The drugs act on the walls of the ureter, relaxing it and thereby activating the mobility of the stone. However, antispasmodics can only eliminate pain, but they cannot rid the patient of the main cause of the disease - the stone.
3. Surgery. This is the most radical treatment for urolithiasis. Surgery is necessary when the stone grows to a large size. As for the incision, it is performed in the place where the stone is diagnosed. After the calculus is removed, specialists drain the area to remove urine that seeps through the bladder wall.

In addition, the procedure for crushing stones - distance-wave lithotripsy - is considered an operative method of treatment. In the process of manipulation, the stones are crushed and then taken out.

Patient recovery period

Within five days after the stones come out, the patient is in the hospital, takes antibacterial drugs, doctors carry out periodic catheterization of the bladder. After 21 days, the patient is closely monitored using an ultrasound scan of the organ, metabolic monitoring.

When the doctor removes calculi with surgical intervention, the patient sometimes has the following complications:

• tamponade and hemorrhage in the bladder;
• postoperative infection;
• damage to the walls of the organ.

Folk remedies and recipes

Natural drugs do an excellent job of eliminating various salt formations from the urine of the stronger sex. The key to successful treatment is the regular use of folk remedies, their correct preparation.

1. Sunflower roots. Rinse the raw materials thoroughly, chop finely, pour into a saucepan, pour three liters of boiling water, cook for five minutes. There are enough raw materials to prepare three portions of the broth, drink the strained broth, half a glass three times a day for one month.
2. Onion tincture. Fill half a jar with sliced ​​onion rings. Pour the vegetable to the top with alcohol or vodka, let it brew for ten days. Take the resulting product two tablespoons twice before meals. The duration of therapy depends on the size of the formations in the bladder.
3. Vegetable juice. Consume 100 grams of carrot / cucumber / beet juice three times a day. You can prepare a mixture of juices, use it twice a day. The course of therapy lasts no more than two weeks; prolonged treatment can lead to the development of allergies to the selected components of the drug.
4. Mandarin Therapy. The method is approved for patients who are not prone to allergies. Consume up to two kilograms of tangerine throughout the week. Take a week break, repeat the therapeutic manipulations.

Before starting therapy, consult your doctor if allergic reactions, choose a different traditional medicine recipe.

Nutrition and diet

Regardless of the place of localization of stones in the body, doctors prescribe therapeutic nutrition to patients - the so-called table number 7.

The main principles of such nutrition include the following points:

• for oxalate formations, limit chocolate, meat, nuts, strong coffee and tea drink;
• if calcium compounds are diagnosed, limit or exclude salt;
• when cystine stones are detected, reduce the consumption of animal proteins;
• in the case of struvite formation, protect yourself from infections of the urinary system, and if they appear, treat them promptly.

Prophylaxis

Since the etiology of urolithiasis is multifactorial, prevention should be the same. First of all, you need to adjust your diet. For the prevention of urolithiasis, it is necessary to exclude or limit fatty foods, smoked meats, pickles, spices and other foods containing a large amount of fat and salt from it.

It is also necessary to remember about the correct water regime. It is considered normal if a person drinks about one and a half liters of liquid per day and goes to the toilet about six to ten times. If your personal performance falls outside this standard, you need to think about your own water-salt regimen.

It is also necessary to take into account the fact that people of sedentary professions are much more likely to suffer from urolithiasis than active workers. Thus, sports can become another means of preventing urolithiasis.

Conclusion

At the first symptoms of the disease, it is necessary to consult a doctor for diagnosis and initiation of treatment. In case of severe pain syndrome, you need to call an ambulance, since such pain rarely goes away on its own, and the patient needs urgent help.

Bladder stones, or cystolithiasis, are one of the forms of urolithiasis. It is characterized by the deposition of saline calculi of different composition in the cavity of the organ. Their differences are due to differences in the mechanism of formation and localization in the organ. They differ in parameters, quantity, chemical composition, type of surface, color, shape and density.

Reasons for the formation of stones

Bladder stones in women appear at any age, while in men they form either in childhood due to the narrowness of the urethra, or in the elderly due to prostate adenoma.

Today, medicine cannot accurately indicate the causes of stone formation in the bladder. Many experts adhere to the basic multifactorial theory, which explains the process of cystolithiasis by many factors.

Here are the main ones:

Bladder stones differ in different ways:

• sizes;
• form;
• surfaces;
• composition.

In terms of composition, they can be:

• Calcium. These are hard, hardly soluble, rough stones. Among them there are subgroups: oxalate, consisting of oxalic acid salts; phosphate, formed by salts of phosphoric acid, easily amenable to crushing.
• Uric acid, or uric acid, are formed by the salts of uric acid. They are smooth and do not injure the mucous membrane of the urinary tract.
• Struvite (formed against the background of bacterial cystitis).
• Cystine (formed against the background of cystinuria). They have a hexagonal shape.
• Protein (formed from protein in urine sediment).

One-piece stones are rare. They often have a mixed composition: urate-phosphate, phosphate-oxalate, etc.

On the etiological basis, stones in the bladder can be primary, that is, they immediately formed in it. Secondary stones enter it from the kidneys and ureters.

Bladder stones symptoms

The symptoms of bladder stones are varied, but they cannot be called specific to this disease. If the stone moves into the bladder and has not yet descended into it, then the symptoms of the disease appear in pains of varying strength. It can be pain in the lower abdomen in the suprapubic region; in men, pain can be given to the perineum and to the penis. It increases with urination, with a change in body position.

If a stone has formed in the bladder itself or has already safely descended into it through the ureter, then the symptoms will be different. Painful sensations are mild, aggravated by urination or during intercourse. It is possible to determine the presence of a stone at the moment it overlaps the orifice of the urethra. It can be a sign of interruption of the urine stream or its complete blockage. Acute urinary retention can be replaced by urinary incontinence if the internal sphincter of the bladder does not close due to a stone overlapping it.

Diagnostics

The main diagnostic methods for bladder stones are:

• general urine analysis;
• cystoscopy.

Additional methods:

• Rg-gram of the urinary tract;
• cystogram.

Excretory urography, previously one of the main diagnostic methods, is now receding into the background. It helps to determine the state urinary tract, the presence of stones, bladder diverticulosis (multiple protrusions of the walls of the organ, in which urine accumulates and stagnates). The radiopacity of stones is influenced by their composition, before the calcium content.

Now the main diagnostic method- ultrasound examination of the organ. It is more informative, accurate, fast and non-traumatic for the patient. For ultrasound, there is no need for intravenous catheterization of the patient and for the introduction contrast agent... Ultrasound examination determines in the bladder hyperechoic formations with an acoustic shadow, moving in the cavity of the organ in different positions of the patient's body.

Even more accurate diagnostic research- CT scan. Its essence is that a number of body shots are taken in different projections. This makes it possible to most accurately determine the location, size and location of stones.

The complex diagnostics also includes instrumental and laboratory research and a carefully collected anamnesis. A general analysis of urine shows leukocytes, erythrocytes, bacteria and salts in it. Cystoscopy allows you to see through the endoscope the condition of the mucous membrane of the bladder walls, the presence tumor formations and calculi.

How to treat stones

Treatment can be divided into acute relief and basic therapy. Antispasmodics are effective in eliminating an acute attack. They have a relaxing effect on the walls of the bladder, relieving pain. But antispasmodics do not remove stones from the organ, therefore, sooner or later, basic therapy is applied.

Small stones and sand are removed from the bladder on their own with urine. If during the examination no large stones are found, then conservative treatment... It consists in the appointment medications that alkalize the urine, and following a diet to control stone formation. Drug treatment includes:

• antispasmodics and analgesics;
• preparations with goldenrod;
• antibiotics.

With urate stones, litholytic therapy is carried out, the dissolution of calculi by taking special drugs that allow you to dilute the urine. Today, minimally invasive treatment methods are used in urology. Their advantage is less blood loss, less stress for the patient, fewer complications and a shorter recovery period. With a large number of stones or with their large size, treatment of stones in the bladder consists of fragmentation and removal from the organ by contact or remote method (lithotripsy), or surgical method during an open operation - cystolithotomy.

The use of a remote method using ultrasound or a laser is possible if the diameter of the calculus does not exceed 3 cm. Open surgery is performed if another method could not remove the calculus and was ineffective. Endoscopic methods are most effective:

• Cystoscopy, when a special apparatus is used - a cystoscope. It is inserted through the urethra into the bladder. This is a metal tube of a certain diameter with an endoscope. With its help, the mucous membrane of the walls of the bladder and the mouth of the ureters is examined. A cystoscope is used not only to inspect the walls of the bladder, but also to introduce instruments through it, for example, a lithotripter - a stone crusher - and the stones are fragmented.
• Transurethral cystolitolapaxy... Stone crushing is performed after cystoscopy. The destroyed stone is removed through a cystoscope. This method is used in the treatment of adult patients. Most patients with bladder stones are men. The main factor in cystolithiasis is prostate adenoma. Therefore, the removal of stones from the bladder in men is done together with the removal of the adenoma. This operation is also performed endoscopically.
• Percutaneous suprapubic litholapaxy used in the treatment of children. The method is fast and safe for the patient, it allows crushing the calculus.
• Open abdominal surgery used very rarely. The indications for it are the large size of the calculus, which cannot pass through the urethra even after crushing.

Indications for surgical treatment:

• recurrent cystitis;
• acute urinary retention;
• lack of effect from other methods of therapy;
• hematuria (blood clots in the urine).

Operational methods of treatment are carried out under various types of anesthesia. The choice of pain relief method depends on the severity of the patient's condition and the decision of the anesthesiologist.

Recovery period

During this period, bladder catheterization is necessary and antibacterial drugs... On average, its duration is 5 days. For another 3 weeks after the hospital, the patient needs to be monitored and controlled with an ultrasound of the bladder, metabolic monitoring. Patients are transferred to dietary table No. 7 with restriction of salt, fats, alcohol, spices and other products that can cause stone formation. After surgical treatment to remove stones, there is a certain percentage of complications:

• postoperative infection;
• damage to the bladder wall;
• bleeding and bladder tamponade.

But the percentage of these complications is insignificant. The effectiveness of transureral cystolitolapaxy comes out on top among other methods of treating this disease.

Treatment with folk remedies

Treatment of bladder stones with folk remedies will only give an effect if there are small stones and sand, which you can get rid of on your own. Recently, horsetail tincture has been successfully used for this purpose. Its dissolving properties in relation to urinary stones have even been recognized by official urology. But in more complex variants of the disease, the use of horsetail tincture is impossible.

Forecast and prevention

The prognosis of the disease depends on what factors interfere with the normal outflow of urine. With the elimination of this factor, the prognosis is favorable, although according to observations of patients who underwent surgical removal of stones from the bladder, relapses of the disease occur in 50% of patients within 10 years after surgery. Therefore, it is so important to eat well even after surgery to remove stones from the bladder. Knowing the tendency of stone formation in your body, you can apply an appropriate diet that will help curb this process. For example, here are the types of diets that can be used with stones of the following composition:

• calcium - salt-restricted diet;
• oxalate - restriction of chocolate, coffee, tea, meat, nuts;
• cystine - restriction of protein foods, especially meat;
• struvite - avoiding any urinary tract infections.

So, following the recommendations of the urologist, leading an active lifestyle, eliminating bad habits, constantly monitoring the state of the urinary tract through annual preventive examinations, the patient, after removing stones from the bladder, can lead a full, high-quality life for many decades.

Bladder stones are complex deposits of insoluble salts (most often calcium, uric acid). Usually, the formation of calculi is associated with a violation of the process of urine drainage from the bladder.

In healthy young people who do not have any prerequisites in the form of anatomical defects, strictures, infectious pathology or foreign bodies, urolithiasis is recorded less often.

Show all

1. How are bladder stones formed?

The main manifestations of urolithiasis are:

1. 1 Pain and discomfort over the bosom. Pain can be dull and intensify with sudden movements, physical activity... Adopting the patient's position on the side or lying down leads to relief of pain, sometimes to the passage of urine due to the removal of calculus from the neck of the bladder and opening the internal opening of the urethra.
2. 2 Dysuric symptoms: pain, increased frequency of urination, the appearance of intermittent urination. Sometimes the patient is worried about the sudden cessation of the jet along with the appearance of pain above the bosom, in the scrotum, in the perineum, in the lower back. This symptom is explained by the rolling of the stone in the area of ​​the bladder triangle, followed by muscle spasm and blockage of the proximal urethral opening. When changing body position, delay and pain syndrome can be eliminated.
3. 3 The appearance of blood clots in the urine, its coloring in red (gross hematuria). With a slight increase in the number of red blood cells, urine does not stain pink and red, in this case we are talking about microhematuria. Microhematuria is registered or.

5. Diagnostic measures

Conversation with the patient and taking anamnesis are mandatory for the diagnosis of urolithiasis. First of all, the doctor asks the patient about the symptoms and their possible causes, clarifies the possibility of the hereditary nature of the disease, finds out the presence of concomitant diseases, previous operations (including on the pelvic organs).

On palpation above the bosom, the doctor can determine the tension of the muscles of the abdominal wall, with acute delay overflowing, tense and painful bladder is palpable. Women should be examined for cystocele, enterocele.

5.1. General urine analysis

Indications for cystotomy:
1. 1 Large calculi (more than 4 cm in diameter).
2. 2 Availability of indications for simultaneous surgery on the prostate and / or bladder: indications for open prostatectomy (prostate weight more than 80-100 g), the presence of wall diverticula.
3. 3 Lack of effect from minimally invasive treatment methods.

Benefits of cystotomy:

1. 1 Speed ​​of execution.
2. 2 It is easier to remove calculi that have grown together with the mucous membrane.
3. 3 Ability to remove large and hard stones that do not lend themselves to fragmentation.

The main disadvantages of cystotomy:

1. 1 in postoperative period patients note a more pronounced pain syndrome in comparison with minimally invasive techniques.
2. 2 Longer rehabilitation and hospitalization.
3. 3 Higher likelihood of postoperative complications.

9. Follow-up after surgery

A month after the intervention, the patient undergoes a plain urogram and ultrasonography to identify residual stones. If they are absent, a second examination is prescribed in six months and a year.

The patient remains under the supervision of a doctor; pathological changes in the general analysis of urine, biochemical analysis of blood and urine are assessed in dynamics.

The study of the chemical composition of calculus is indicated for patients with urate stones, stones of the upper floor of the urinary system, with a burdened family history, recurrence of urolithiasis and its identification without the presence of risk factors.