Urolithiasis - symptoms in women, men, treatment

Urolithiasis is an urgent problem for modern urology due to its high prevalence and the possibility of complications.

Recently, the frequency of this pathology ranges from 25 to 40% in the overall structure of urological diseases, with a steady increase in prevalence.

In terms of the chemical structure of stones, urolithiasis is classified into the following types:

urate acid diathesis;
phosphoric acid;
oxaloacetic.

Causes of urolithiasis

Speaking about the causes of urolithiasis, it is common to identify the main causative factors and secondary.

The main ones are:

1) Insufficient activity of proteolytic enzymes of urine, which creates conditions for the formation of the organic matrix of the stone.
2) Change in the acidity of urine, which creates conditions for the crystallization of salts in the urine( the chemical composition of the stone depends on this).

Secondary causes of urolithiasis( urolithiasis) are:

infectious diseases of the urinary system;

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mineral sand in the urine;
presence of pathological impurities in the kidney in the form of tissue detritus, blood clots, pus and mucus.

Probability of formation of stones in the presence of sand in the urinary tract depends on its composition. So, if we are talking about urine acid diathesis, then it is 15-25%, and in the presence of phosphate diathesis - it rises to 70%.

Similar data can be given for the recurrence of stone formation after surgical removal.

Symptoms of urolithiasis in women and men

In women and men, the course of urolithiasis consists of two main periods, each characterized by its own symptoms:

1) An asymptomatic stage in which clinical signs of the disease are absent and can only be diagnosed with additionalmethods of research.
2) Stage of clinical manifestations, which may include renal colic, acute urinary retention. This or that variant will depend on the localization of the stone.

Renal colic manifests itself following symptoms:

acutely occurring pain in the lumbar region;
a constant desire to change the situation( such patients are extremely restless);
bloating;
stool disorder;
urge to urinate, which are false;
delayed exhaust gases;
slight increase in body temperature;
nausea and vomiting;
in the general analysis of urine is determined erythrocytes, the level of which can be different.

In the case of ishuria( acute urinary retention), there are signs such as:

the patient can not urinate, even with a strong desire;
discomfort in the lower abdomen due to a crowded bladder;
urine can only be removed with a catheter.

Diagnosis of urolithiasis

Diagnosis for suspected urolithiasis includes conducting studies that will visualize the stone.

These studies include:

1) Ultrasound, but not all concrements can be seen with ultrasound.
2) Overview urography, which allows you to get a general idea of the stone - its size, location, possible chemical composition, etc.
3) Excretory urography is performed as a second stage after a review. In this study, a contrast agent is injected into the vein, and then it enters the organs of the urinary system, which allows one to assess their condition. The location of the localization of the stone is determined by the defect of filling by contrast.

In addition, a number of laboratory tests may be required to assess kidney function and possible secondary risk factors.

Such studies are:

1) General clinical analysis of urine, in which the increase in the level of leukocytes and the shift of the formula to the left can be determined as signs of an inflammatory process.
2) Clinical analysis of urine. The appearance of erythrocytes in it is a sign of traumatizing the urinary tract with a stone. If there is an increased amount of white blood cells, then this is regarded as a symptom of the inflammatory process.
3) Biochemical blood test with determination of creatinine, total protein and uric acid to assess renal function and to diagnose some degree of renal failure.

Treatment of urolithiasis

Complex conservative therapy of urolithiasis in men and women depends on the chemical composition of the stone. In the presence of urates( uric acid stones) the following treatment is performed:

1) Drugs that reduce the formation of uric acid and promote its excretion from the body. It can be such as Allopurinol, Allomaron and others.
2) Urine based alkalizing agents based on citrate( Uralit, Magurlit).
3) Preparations created on a plant basis( Kanefron, medicinal herbs with a diuretic effect).
4) Various enzyme preparations that allow you to dissolve the organic base of the calculus( Panzinorm, Festal, Papaya).

Arsenal treatment of calcium stones is more limited. The following preparations are indicated:

herbal preparations with a similar mechanism of action;
vitamins from group B and vitamin D;
drugs that accelerate the excretion of excess calcium present in the urine( Cystone, Xidifon).

For the treatment of phosphate stones, it is necessary to use drugs such as:

acidifying urine( Methionine, ammonium chloride);
preparations that possess an antiphosphoric effect( Almagel);
antibiotics in combination with herbal preparations and medicinal herbs.

However, regardless of the chemical composition of the stone, it is necessary to influence the secondary causes that led to the development of urolithiasis.

To this end, the therapy is carried out in the following areas:

antibiotics, taking into account the result of bacteriological urinalysis;
improved blood supply to the kidneys with antiaggregants and Kanefron;
timely evacuation of the bladder in a natural way.

In addition to conservative therapy, sometimes you have to resort to surgery to remove stones. As a rule, at the present time, remote lithotripsy is used, in which the stone is broken down to small particles. Then they are excreted in the urine from the body. The need for large surgical interventions arises only in the presence of complications from the organs of the urinary system.

Treatment aimed at preventing recurrence of urolithiasis must be comprehensive and based on the following principles:

phytotherapy - application of medicinal plants with long courses;
diet therapy with the exclusion of products that promote the formation of concrements;
pharmacological correction;
sanatorium treatment, which implies a general improvement of the person.

See also how to treat stones in the bladder.

Complications of

Against the background of urolithiasis, various complications can occur that are associated with prolonged locus of the calculus in the urinary tract.

The main ones are as follows:

1) Inflammatory lesion of any organ of the urinary system, where the stone is localized. It can be pyelonephritis( inflammation of pelvis and calyx buds), cystitis( inflammation of the bladder), urethritis( inflammation of the urethra).
2) Paranephritis - the transition of the inflammatory process from the kidney to the surrounding cellulose;
3) Chronic failure of kidney function;
4) Acute urinary retention( ishuria);
5) Chronic anemia on the background of repeated bleeding, and as a result of inhibition of the synthesis of erythropoietin in the kidneys.

Prevention of urolithiasis

The main preventive measures that prevent the development of urolithiasis are:

sufficient rhythm of physical activity;
elimination of alcohol from use;
quitting;
weight loss;
increase in the number of liquids drunk during the day;
a sufficient amount of plant fiber in the diet;
restriction of the use of animal protein in the diet, which can be an organic basis for the formation of concrements.

Forecast

Timely treatment of urolithiasis is the basis of a favorable prognosis for this disease. To prevent the recurrence of urolithiasis after surgical removal of stones, prolonged pathogenetic therapy is indicated.

It should consider the following factors:

presence of infectious diseases of the urinary tract;
the presence of renal failure;
urine acidity status;
chemical composition of remote stones.

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