Stones in the bladder and ureter - Causes, symptoms and treatment. MF.
Jun 18, 2018
Urolithiasis is a pathology characterized by the formation of concrements in the kidneys, ureters, bladder and urethra. In this article, stones of the ureter and stones in the bladder will be examined in detail.
Causes of the formation of stones in the urinary tract
To date, no one can name the exact cause, from which stones are formed in the ureters or bladder. Most of the world's scientists adhere to the multifactor theory, according to which, several factors influence the formation of concrements.
Probably the most significant of all the large number of risk factors is the wrong diet, namely the water-salt regime. Many scientists and practical urologists believe that stones in the bladder and ureters are formed from the excess amount of salts in the body. At the same time, it is not necessary that this excess amount of salts falls with food or water. Violation of kidney function, in which an inadequate amount of sodium is excreted, also contributes to a change in the normal composition of urine, which subsequently leads to the formation of concrements.
Inflammation of the mucous membrane of the urogenital canal can also lead to the appearance of stones. This is because the protein substances that are produced as a result of the inflammatory process, can serve as a kind of matrix for stone formation. Thus, the salt composition of urine can be absolutely normal.
Some influence on the development of urolithiasis is also played by the place of residence of a person. Multiple studies have shown that in regions of the tropical and subtropical climatic zone people are more likely to have urolithiasis than, for example, in the northern regions.
Symptoms of stones in the bladder and ureter and associated symptoms
The clinical picture of finding in the ureter is quite specific. In this case, there is a so-called renal colic, which is characterized by a sharp pain in the lumbar region on the side of the affected kidney. This pain can be given to the crotch of the external genital organs or to the front surface of the thigh. In addition, for renal colic, a characteristic positive symptom of Pasternatsky. It is characterized by the fact that even with a slight tapping of the fist in the kidney region, the patient is marked by a significant increase in pain or the appearance of the latter.
In addition to acute pain syndrome, with a similar pathology, changes in urine are very often observed, which are characterized by the presence of blood, salts, sand or even small concretions( sand).This must be taken into account for differential diagnosis of urolithiasis with another pathology.
If the stone has already descended from the ureter into the bladder or formed directly in it, the signs of it are different. Symptoms of with stones in the bladder are less pronounced, but even for them you can establish an absolute diagnosis. In this case, there will be a small amount of blood or sand in the urine, as well as periodic aching or cutting pains in the perineal region, which increase during intercourse or urination.
If the stone of the bladder moves smoothly in its cavity, then at some point it can overlap the mouth of the urethra. Most often, it is observed during the act of urination and is manifested by the interruption of the jet.
Different types of stones
If you notice a pain in the lumbar region or a characteristic change in the urine sediment, then you should immediately contact a urologist who will be able to prescribe additional studies and make a final diagnosis.
Diagnosis of stones in the bladder and ureter
The most common, but at times most effective in bladder and ureter stones is a general urine test. In this study, you can identify the exact amount of blood, salts and other pathological substances that may be present in the urine in this pathology. The analysis is screening, as it is only the first step in the diagnosis of urolithiasis.
Twenty years ago excretory urograph was considered the most informative and accurate in the diagnosis of urolithiasis. This procedure is a diagnostic technique, which consists in the intravenous administration of contrast medium followed by radiography of the abdominal cavity. This study provided an opportunity not only to see X-ray positive stones of the ureter and bladder, but also to determine how well urine is excreted or not released through the urethra.
Excretory urography is the stone of the left ureter.1 - shadow of the stone;2 - stasis radiopaque substance in the enlarged ureter.
But depending on their origin, the stones may not appear on the x-ray, this divides them into x-ray positive and x-ray negative.
To date, after the advent of , the ultrasound, excretory urography has somewhat receded into the background. This is due to the fact that ultrasound results are much more accurate and much faster. In addition, to conduct ultrasound, there is no need to put an intravenous catheter, which in any case is considered an invasion and threatens with infectious complications. And even if we consider this problem from a financial point of view, ultrasonic research is much cheaper.
Another innovative technique in the diagnosis of urolithiasis is the computed tomography , which gives even more accurate results than ultrasound. The essence of this study is that a whole series of body images is made in different sections, which makes it possible to accurately estimate the size and position of the stones. The only thing that stands in the way of widespread introduction of computed tomography in the clinic is the cost of the procedure, which today is beyond the power of people with average incomes.
Treatment of urolithiasis
Treatment of stones in the ureter and bladder can be divided into acute treatment and basic therapy. As for the acute attack, various lytic mixtures based on antispasmodics are used very effectively to remove it. These drugs, such as spasmalgone, baralgin, but-spa, papaverine can be bought without a prescription in any pharmacy. They can be used in tablets, but as practice shows, intravenous or intramuscular injection is considered more effective. These drugs, relaxing the wall of the ureter, promote the passage of the stone through the canal and its prolapse into the bladder. It must be remembered that spasmolytics only eliminate an acute attack, but in no way relieve the main cause - concrement.
If the stone is not given to conservative treatment, then an acute attack of renal colic can be eliminated with a special device - a cystoscope. This metal tube with optics inside is inserted into the urethra, after which the mucous membrane of the bladder and the ureteral mouth are examined. After that, in one of the holes of the ureter, where there is a problem, a thin tube called a stent is inserted. It promotes the flow of urine from the kidney into the bladder, even in a situation where it "sits" tightly in the ureter.
A radical method of treatment for urolithiasis can be considered only surgery, because only it eliminates the immediate cause of the pathology - stone. The incision during surgery depends on the area in which the stone is located. After removal of the calculus, the surgical field is drained to remove urine, which can flow through the stitched wall of the bladder or ureter.
Nutritional characteristics and lifestyle with stones in the ureter or bladder
For any type of urolithiasis, patients are advised to take table number 7, which is to limit the intake of salt, fatty foods, alcohol, spices and other extractives. Patients who suffer from urolithiasis must be protected from hypothermia and excessive physical exertion, which can lead to inflammation of the urinary tract, irritated with calculi.
Rehabilitation after illness
All patients who underwent surgery need bed rest for several days. In addition, they need daily dressings and care for the operating wound.
In the late period, patients with urolithiasis are recommended to resort treatment with mud and mineral waters. Very good for such a category of patients resemble sanatoria such as Truskavets, Morshin and Polyana.
Treating stones in the bladder with folk remedies
Treating folk remedies against urolithiasis is impossible just as far as it is impossible and healing with classical medicines. Nevertheless, tincture of horsetail has shown itself very well as a means for resorption of concrements and is now actively used even by representatives of traditional medicine. However, when using this medicine, you must be extremely careful not to get on your teeth, because this can destroy the enamel.
Complications of stones in the bladder and ureter
Complications of kidney stones should be considered a violation of kidney function, which often leads to inflammation of the latter and the formation of an abscess in its cavity. This condition often ends with an operation, the volume of which may even be to remove this organ.
In bilateral renal colic, when the outflow of urine from both kidneys is disturbed, it can develop by infection of the blood, which is called uremia. In such a situation, the condition of patients deteriorates sharply and approaches a critical one. Uremia can threaten death for patients, therefore it is necessary to be extremely careful in the treatment of urolithiasis in order to prevent such a condition in time.
Prevention of calculi in the kidney and ureter
Because the etiology of urolithiasis is multifactorial, prevention should be the same. First of all, you need to adjust your diet. For prevention of urolithiasis, it is necessary to exclude or limit fatty foods, smoked products, pickles, spices and other products containing a large amount of fat and salt from it.
Also it is necessary to remember the correct water mode. It is normal if a person drank about one and a half liters of liquid a day and goes to the toilet approximately six to ten times. If your personal indicators go beyond this standard, you need to think in your own water-salt regime.
It is also necessary to take into account the fact that people in sedentary occupations suffer much more from urolithiasis than active workers. Thus, sports can become another means of preventing urolithiasis.
Doctor urologist Startsev V.Yu.