Large kidney stones. Urolithiasis: treatment depending on the size of the stones

Alexander asks:

Hello. I am 25 years old. After an ultrasound examination (kidneys, liver, gall bladder), a (small) stone was discovered in the left kidney. I had an ultrasound in November 2010. The doctor prescribed CYSTON pills 2 tab. 2 times a day. 200 pcs., 100 tab. I've already drunk. I would like to know whether the kidney stone will come out on its own or will it dissolve in the kidney? Or advise how to remove it!!! Thank you in advance!!!

Treatment tactics for kidney stones depend on their size. Please specify the size of your stones - this information is available in the ultrasound report.

Julia asks:

I was taken away having a seizure. One stone is in the kidney and the other is in the ureter. There is 7 ml in the kidney, and 3 ml in the ureter (or rather at the mouth). I was discharged, the kidney attacks went away, but the stone did not pass. Please advise!

You definitely need to see a urologist for an examination and further treatment. Since the presence of a stone in the ureter can lead to obstruction of its lumen, which can cause irreversible changes in the corresponding kidney.

Elena asks:

Hello! An ultrasound revealed a left kidney calculus with a vague acoustic shadow. The doctor prescribed only Fitolysin paste. Drink for 3 months. Is this really enough? I'm in doubt...

Fuzzy contours of the calculus may indicate that it is still loose and soft and has not yet completely hardened. Perhaps using Phytolysin for three months will be enough to dissolve it and remove it from the body.

Olga asks:

I am 27 years old. For three days there was pain in the left side. An ultrasound scan showed a kidney stone measuring 5 mm. I don’t have colic, but my left side feels like there’s a stone. What to do to make the pain stop

First of all, you need to pass general analysis blood and general urine analysis to exclude an inflammatory process in the genitourinary system. With the results of the examination, you will need to seek a personal consultation with a nephrologist for a more accurate diagnosis and treatment. Before visiting a doctor, you can take No-shpa to relieve pain, however, you need to undergo an examination as soon as possible.

Marina asks:

A stone of 0.8 cm was found in the left kidney. After a month of taking UROLISAN, PROLIT SUPER and CISTON, the size decreased by 0.2 cm. All drugs were prescribed by a urologist. How can I remove it completely??? Can it be used in in this case traditional medicine?
There is no inflammation.

Please tell me, have you done a general urine test since the start of treatment, what salts were present in the urine, urates or phosphates?

Anton asks:

My son is 12 years old and has been diagnosed with urolithiasis. He has a 0.1 mm stone in his left kidney, and 0.5, 0.6 mm stones in his right kidney. We completed a course of treatment and took tests to determine the chemical composition of the stones. The child’s right kidney constantly hurts, he feels very nauseous, and there is blood in his urine. Please help me what can be done to get rid of stones.

Urolithiasis is quite common, due to poor quality nutrition and unhealthy image life. Today, there are many methods of both surgical and drug treatment stones. The treatment method depends on the size of the stone. and what should the patient do?

The kidneys perform a very important function in the body; they remove all toxins from the blood. Sometimes these harmful substances crystallize and settle in the kidneys, in which case a stone appears.

Kidney stones most often consist of calcium, but sometimes they may contain uric acid or proteins.

With small sizes up to 5-7 mm, the stone can pass out of the kidney along with urine. But if its size reaches 10 mm, then it remains in the kidney and can cause severe pain. If a stone gets stuck at the exit of the kidney, then complete urinary retention occurs. In this case, immediate surgical intervention.

Without proper treatment and prevention, stones tend to grow. Their growth depends on the body’s tendency to form stones, as well as diet and the amount of fluid you drink. Initially, they can be the size of a grain of sand, and over time reach 10 or 15 mm.

Almost all stones up to 5 mm in size can pass out on their own in the urine; about half of kidney stones ranging in size from 5 to 10 mm also pass out without additional intervention from doctors (antispasmodics and diuretics are used).

Once formed, the stone may pass within three weeks or within a month after the first symptoms appear.

But very often, stones in patients with a predisposition to stone formation do not pass away on their own without treatment; their number only increases. If you do not take any preventive and therapeutic measures, you may be left without a kidney.

Prevention

Patients with sand in the kidneys should adhere to the following recommendations:

Drink more than 2 liters of fluid per day. In this case, the kidneys will be well cleaned of sand and all accumulated salts. The urine will become clear and odorless. In summer, when it is very hot, it is recommended to special procedures to cleanse the kidneys. You need to drink half a liter of water at a time or a liter in 30 minutes.
Cleanse the kidneys. consuming diuretic products. So, watermelon has a diuretic effect.
Take long distance walks daily. Walk on fresh air A minimum of two hours is recommended.
Don't get too cold. In cool weather, the lower back should always be kept warm, because hypothermia can provoke inflammation of the kidneys, and as a result, urolithiasis.
Use protection during sexual intercourse. In order to prevent infection with genitourinary infections, because the infection can spread to the kidneys, if the act was not protected, it is necessary to urinate after it.
Observe . You should not consume chocolate, cocoa, coffee and strong tea in large quantities. It is useful to drink decoctions of diuretic herbs.
It is advisable to drink purified water. From heavy metals and salts (filtered or bottled).

But it is not always possible to prevent the onset of the disease with the help of prophylaxis, especially if the patient already has stones in the kidneys large sizes. What to do, how to treat stones of small, medium and large sizes?

Treatment methods

Depending on the size of the stones, as well as the patient’s health condition, the following treatment methods are available:

Phytotherapy. Application herbal preparations helps not only to get rid of inflammation, but also to dissolve stones up to 5-7 mm in size. They use Canephron, Phytolysin, as well as knotweed and half-fallow herbs.
Destruction and crushing of stones.
Surgical removal.

Let's look at each of these methods in more detail. In what cases does one method or another apply? Treatment involves not only removal, but also restoration of the body, and prevention of the occurrence of stones in the future.

Surgery

Surgical treatment is carried out endoscopically or laparoscopically. The recovery period, as well as possible complications after these types of operations, are minimal. Surgical intervention is performed without incision of the kidney and skin, the instrument is inserted through natural ways: lumen of the urethra, bladder cavity, ureter and kidney.

Surgery is performed in cases where it is not possible to dissolve or crush the stone or it is large in size.

If the stone grows more than 20 mm, then open surgery is performed. This kind surgical intervention It is very traumatic and has many complications. During this type of operation, the kidney is cut and all contents are removed.

Crushing stones

The destruction of stones can be done by contact or through a puncture.

When destroyed surgically, the stones are removed using a special metal tube - a nephroscope. It is inserted through a puncture in the lumbar region. Through the nephroscope you can enter various instruments for crushing and removal. Most often, this method is used if the patient has only one big Stone, which cannot be dissolved with medications.

During contact destruction and removal, the instrument is inserted through the urethra. Having reached the stone, crushing occurs with its help. Crushing is performed only for small stones, since a large fragment can close the lumen of the kidney.

Shock wave lithotripsy is considered an effective crushing method. It is carried out for stone sizes from 5 mm to 25 mm. This is the most gentle method, because there is no need to make punctures. Destruction occurs under the influence of radio waves.

In addition, there are laser, ultrasound, electrohydraulic and pneumatic lithotripsy.

Drug treatment

If the stone has a size of up to 5-7 mm, then it is, namely, medicinal dissolution. This method is the safest and most gentle. If everything is done correctly, the stone will come out on its own.

For medical dissolution the following drugs are used:

Canephron. It has anti-inflammatory, antibacterial, diuretic and antispasmodic effects. Promotes the removal of stone fragments.
Asparkam. Promotes the dissolution of salt, uric acid, calcium or phosphate stones.
Madder extract. Used to dissolve phosphate stones. It cannot be used simultaneously with Cyston.
Urolesan. Dissolves urinary stones and relieves spasms.
Xydiphone. Used to dissolve phosphate and oxalate stones.
Blemaren. A very effective drug for getting rid of stones mixed type.
Allopurinol. Helps reduce the concentration of uric acid in urine.
Cyston or Spill. Suitable for dissolving oxalate stones.

It is worth remembering that all medications should be used only as prescribed by a doctor, because self-medication can lead to a deterioration in health and ending up on the surgical table. The urologist will help determine the type of deposits and select the appropriate drug.

Salt formations can become lodged in the urethra, urethra, and bladder outlet. In modern medicine, stone removal from the ureter, as well as from other structures of the urinary system, is widely used. There are many ways: from drug therapy And different types crushing before surgical removal. Based on the sizes, chemical composition formed crystal, only a doctor can answer the question of what to do in a specific clinical situation.

Dissolution of ureteral stones with medications

With planned treatment, it is possible to expel a stone from the ureter with the help of medications. This technique is used to grind small formations. Small grains of sand come out on their own painlessly. Those that are larger fall into fragments under the influence of drugs. The urologist selects the drugs based on the chemical composition of the stone:

Urates are treated in most cases with allopurinols (Sanfipurol, Zilorik). “Canephron N”, “Blemaren”, “Urolesan” act quickly.
Phosphates are broken down by Marelin, which is based on plant components from madder.
Oxalates are removed with the help of “Prolit” and drugs for alkalizing urine.
For the treatment of cystine formations, Penicillamine and Tiopronin are prescribed.

To speed up the passage of stones from the ureter, antispasmodics are recommended - “No-shpu”, “Papaverine”. By relaxing the smooth muscles of the affected organs, they promote the rapid and painless passage of stones. In parallel, you can use painkillers Tempalgin and analgin. In case of inflammation of the urinary tract, as well as for prevention, the doctor may decide to prescribe antibiotics. There are no guarantees that the stone will disappear.

Return to contents

How to remove it using modern medicine methods?

The stone removal method (lithotripsy) allows you to destroy stones in the urinary tract without interfering with the human body using instruments.

If conservative treatment fails to remove the stone from the ureter, more radical techniques are needed. In current urology, their range is quite wide: catheterization, urethroscopy, remote and contact lithotripsy, percutaneous nephrolithotomy, surgery. To understand which of them will give results in specific case, the doctor prescribes:

general blood analysis;
electrocardiogram;
general urine analysis;
urine culture;
urography.

Return to contents

Endovesical method

If a stone larger than 8 mm is stuck at the mouth of the ureter and cannot move on its own, catheterization is prescribed. This technology is popular among endovesical therapy. The technique is effective for difficulty urinating and renal colic. Its essence consists in introducing medications into the urinary canal that enhance peristalsis (Novocaine, Papaverine, Formitol). To achieve the result, the procedure is repeated several times; thin catheters are often used: about 50 cm long and 1-3 mm wide.

In addition, the removal of stones from the ureter can be done using electrical stimulation of the upper urinary tract through catheter electrodes. In the medical arsenal, many ureteral loops have been proposed for the removal of solid formations. They are not recommended when the stone is lodged above the iliac vessels. If these methods fail to help the patient, the ureteral orifice is dissected and the calculus is released within 2-3 days. According to some experts, this method entails narrowing of the ureter and reflux.

Return to contents

Urethroscopy: stone removal through the urethra

Examination of the urethra with a urethroscope probe makes it possible to see specific sites of inflammation.

If a stone no larger than 1 centimeter has reached a third of the ureter or is lodged in its lower part, ureteroscopy is resorted to. Removal of a stone from the ureter through the urethra is carried out with a flexible instrument equipped with forceps, a camera and a basket. The procedure is painless, as it is accompanied by anesthesia and occurs without a single incision; the urethroscope is inserted into the urethra naturally. After completion, a catheter is inserted to flush the urethra. A significant disadvantage of urethroscopy is severe pain after anesthesia, inclusions of blood in the urine, burning sensation, frequent urge which can last up to 3 weeks. Such sensations are relieved with painkillers.

Return to contents

External lithotripsy

This term in medicine refers to the crushing of stones using a special apparatus that produces waves.

and if they hit them, the pebble crumbles and is washed out with urine over time. The procedure is not traumatic; it is performed if the crystal does not exceed 5 mm in diameter and is clearly visible on x-rays. Among the contraindications: beginning inflammatory process, strong painful sensations and occlusion of the ureter. External lithotripsy is considered ineffective, since when stones are destroyed, the surrounding organ walls suffer, and repeated procedures are often required.

Return to contents

Contact lithotripsy

Contact lithotripsy is performed in an operating room under anesthesia, the type of which is determined individually and is determined by the patient’s age, duration of the operation, and the presence of concomitant diseases.

This method for removing stones is more effective and is considered one of the main types of stone crushing. It lies in the features of various equipment that are involved in the process:

Pneumatic - the formation is broken through the urinary canal with a destructive jet of air. Its fragments are removed with forceps through a small incision. The disadvantage of this method is that it cannot cope with dense formations.

Laser - waves are directed to the calculus through the urethra. The procedure is performed under general anesthesia and does not destroy soft fabrics ureters. The advantage is that the laser destroys even the densest rock formations.
Ultrasound - performed using an ultrasound machine. By producing waves, it crushes stones in the ureter into sand.

Return to contents

Percutaneous nephrolithotomy

If the stone in the ureter exceeds 2 cm in diameter, it is removed with instruments inserted through a small incision. The procedure is accompanied by anesthesia; the stones are removed in crushed form. The method is effective for coral formations, which are characterized by compacted and sharp edges. A nephoscope can be used to extract calcium fragments even from the kidneys. During pregnancy, inflammation and malignant tumors in the urogenitals, percutaneous nephrolithotomy is strictly prohibited.

Return to contents

Surgery

If the stones in the ureter are large and do not come out for a long time, and also provoke infectious inflammation in the urogenitals, severe pain, or block the outflow of urine, they can only be removed surgically. These are emergency measures aimed at saving the kidneys. Almost all urological departments specialize in abdominal operations, in which a specialist opens the ureter, closes the area strangulated by the stone with clamps on both sides and dissects it a little higher. After checking the patency of the canal, sutures are placed. Operations are dangerous due to hemorrhage, tissue damage, associated infections and newly formed hernias. Rehabilitation period After surgery, it may take up to a month.

Return to contents

What to do at home?

Drinking regime is a necessary measure to eliminate the causes of stone formation.

Small stones from the ureter can be removed at home. Removing a stone does not mean curing urolithiasis. Further measures should be aimed at eliminating the causes of stone formation. Add to list necessary measures included:

a diet suitable for a specific type of stone;
physical activity (doctor’s advice is required);
drinking regime(at least 2.5 liters daily);
phytotherapy;
medicinal baths.

Return to contents

Therapeutic bath

If signs of urolithiasis are detected, renal colic torments, the passage of stones is accompanied by unbearable pain, traditional healers offer medicinal baths from herbal decoctions. In particular, they are prepared according to one recipe: 2 handfuls of the collection are poured with 3 liters of boiling water and kept on fire for 10 minutes. After 3 hours, after it has infused, add it to the bath. For this purpose, horsetail, rose hips, Pine cones and branches, oat straw. IN warm baths add essential oils: lavender, thyme, mint, chamomile.

Baths help dilate blood vessels, relax the smooth muscles of the urinary system, improve blood circulation and expand the walls of the ureter. Stones up to 7 mm may pass on their own after the first 10-15 minutes of a warm or hot bath. Longer procedures do more harm than good, since they promote profuse sweating and reduce urine output.

Return to contents

Herbal decoctions

Homemade diuretics have the gentlest effect on the body, having fewer contraindications than synthetic diuretics.

Diuretic tinctures are effective in combination with medicinal baths. It is worth considering that when stone formation is in the kidney, such decoctions can cause significant harm, pushing them to move and causing renal colic and acute inflammation. If the stone is in the ureter, this method can speed up its passage. Use herbal teas from juniper, rose hips, birch and madder, horsetail, rosemary, thyme, lingonberries. Decoctions are prepared from the following ingredients:

Knotweed. 1 tbsp. l. the herbs are poured with boiling water and infused for an hour. Take a third of a glass three times a day.
Chopped rose hips. 6 tbsp. l. berries or roots and 3 cups of boiling water are kept on fire for 5-7 minutes. Drink a glass an hour after meals.
Dry leaves of oregano. 1 tbsp. l. crushed product is poured with 1 cup of boiling water. Bring to a boil and leave to steep for 8 hours.

Return to contents

8 juices from stones

For kidney stones, traditional medicine recommends juices from the following fruits and plants: pomegranates, watermelons, lemons, birch, beets and carrots (in a 1:1 ratio). Drinks must be diluted with water, as in their pure form they can cause dizziness and nausea. Take 1/3 cup 3 times a day, gradually increasing daily dose up to 200 ml. Juices made from parsley, lemon and carrots (1:1 ratio) are suitable. It is recommended to drink such drinks daily, 3 glasses 2 hours after meals. Black radish juice is effective. To prepare it, a hole is made in the root vegetable and filled with honey. After a while, the released juice is collected. Drink a tablespoon three times a day.

Juice therapy is more of a preventative measure and is effective for stones that “sit” in the kidneys. Its results are obvious after a few months.

Treatment with juices should be under the supervision of a doctor, since allergic reactions, ulcers and other complications are possible if the dosage is incorrect. Even table water dissolves urate stones, and oxalate stones are susceptible to alkaline drinking. The liquid you drink will not dissolve solid formations, as well as those that have entered the ureter, bladder or urethra. The movement of the stone can be accompanied by renal colic, causing acute pyelonephritis and many other complications, so quick and accurate therapy is needed here.

etopochki.ru

How kidney stones form and grow

The functions of the kidneys are extremely important - with their help, processed and toxic substances are removed from the body. Under the influence various reasons filtration in the kidneys is disrupted, and salts accumulate in the pyelocaliceal apparatus - most often urinary, oxalic or phosphoric acid. Then they become denser and their volume increases. This formation is called a renal calculus, or stone. Based in the kidney, sooner or later the stones begin to move through the urinary tract. The internal diameter of the ureter (the narrowest place in the urinary tract) does not exceed 8 mm, so sand and small stones measuring three to five millimeters come out without difficulty, without causing discomfort to its owner.

Large stones 9 mm - 15 mm often cause renal colic - an acute condition characterized by sharp unbearable pain in the lumbar region. It is associated with the release of a stone from the kidney and its “stuck” in the ureter. The resulting urinary retention is an indication for emergency surgery.

Giant stones with a diameter of 5 cm or more grossly disrupt the functioning of the urinary organs, compressing parenchymal tissue and preventing the outflow of urine.

To effective and precise methods Diagnosis of the size of kidney stones includes:

ultrasonography;
survey R-graphy and excretory urography;
Magnetic resonance imaging.

In addition, an important diagnostic criterion is the pH of the urine and the presence of pathological inclusions. A shift in the acid-base balance to the alkaline side indicates the probable phosphate composition of the stones, and to the acidic side indicates a urate composition.

Principles of treatment of urolithiasis depending on the size of the stone

Kidney stones can be removed in several ways. They can be divided into:

conservative – diet, medication;
non-invasive - non-contact crushing of stones with their subsequent removal in a natural way;
minimally invasive - the use of endoscopic operations;
surgical – removal of stones from the renal pelvis through open access.

Removing small stones and sand from the kidneys

What methods are available to treat small (up to 6 mm) kidney stones? As a rule, they are based on dietary modification, medication, or modern endoscopic techniques.

Medical nutrition

A specialized “renal” diet and drinking regime will be effective if a kidney stone with a diameter of up to 5 mm: what needs to be done for this? Nephrologists identify the following rules therapeutic nutrition with ICD:

A complete and varied diet with high energy value.
Exception of fatty fried food, hot and spicy dishes, smoked meats, marinades.
With the urate nature of the stones - a sharp restriction of meat and protein foods, legumes, mushrooms containing a large number of purines. Boiled lean meat is allowed to be eaten no more than 2-3 times a week.
If phosphate stones predominate, limit vegetables (except Brussels sprouts, pumpkin) and sour fruits, milk and dairy products, rich broths.
If you have oxalate kidney stones, avoid foods rich in oxalic acid (sorrel, rhubarb, beets, parsley, celery).

Required component conservative treatment kidney stones 2-3 mm is to increase the amount of fluid consumed to 2-2.5 liters. This may be filtered or mineral water, compotes, juices, fruit drinks. An increase in the volume of circulating blood stimulates filtration in the tubules, so kidney stones of 1, 2 or 3 mm are easily washed out of the body.

Another important advantage of the diet is the prevention of the appearance of new stones. Therefore, recommendations on diet and lifestyle are usually the first thing patients diagnosed with urolithiasis hear, regardless of the size and chemical composition of the salt formations.

Plant uroseptics

What else can be done if the patient has been diagnosed with kidney stones with a diameter of up to 2 - 3 (5) mm? Plant-based preparations with uroseptic, anti-inflammatory, antispasmodic and mild diuretic effects are very effective:

Canephron N;
Phytolit;
Biliurin;
Phytolysin.

Lithotripsy

Small formations in the kidney with a diameter of 4 mm - 10 mm can be successfully treated using external lithotripsy - a modern non-invasive method for eliminating kidney stones. Under the influence of ultrasound, the stones are crushed and leave the body naturally with urine. The procedure is absolutely safe, does not cause discomfort to the patient and has virtually no contraindications.

Principles of treatment of large stones

Large formations in the right or left kidney with a diameter of more than 10 mm are a reason for surgical treatment. In this case, if there are no contraindications, minimally invasive methods are preferable:

Percutaneous nephrolithotripsy. Removal of stones using a nephroscope through a small (no more than 1 cm) hole in the skin of the lower back. The operation is performed under local or general anesthesia and consists of two stages - crushing a large stone (more than 2 cm in diameter) and removing its fragments. Requires comprehensive survey before carrying out, is contraindicated in case of pathology of the blood coagulation system and somatic diseases in the stage of decompensation. Transurethral nephrolithotripsy. Removal of stones followed by crushing them through the urinary tract using a special endoscopic instrument - a urethroscope.

Giant salt formations, the size of which sometimes reaches 14-15 cm, are an indication for open surgical intervention through wide access. This operation is technically complex and requires a highly qualified surgeon. It is more difficult than endoscopic and is tolerated by the patient, who faces a long period of rehabilitation. However, abdominal surgery allows you to quickly and effectively remove large stones and, if necessary, eliminate possible consequences ICD.

Stones in the kidneys - serious problem, requiring attention from both the doctor and the patient. Patients with nephrolithiasis are twice as likely to encounter infectious and inflammatory diseases and hydronephrosis. Without timely treatment ICD can cause serious complications and even death.

pochkizdrav.ru

Symptoms

Throughout his life, a person may not realize that there is a stone in his kidney. It all depends on the size and location of the stone. Usually when there is a stone in the kidney big size, then he will immediately make himself known. And if a stone, leaving the kidney, begins its movement along the ureter, the person begins to experience excruciating pain. A person with urolithiasis may suddenly develop renal colic, which is accompanied by severe pain in the lower back. A dull pain on the sides may be felt when physical activity, or when changing body position. The main symptoms of kidney stones are frequent urination with pain, this indicates that the stone is in the urinary system. When urinating, the stream of urine may suddenly stop, and the patient, in turn, may not even feel it. Doctors call this phenomenon “congestion syndrome,” that is, with a change in body position, urination may continue. Symptoms of kidney stones also include high pressure, temperature increase up to 40%, swelling. During physical activity or severe pain, blood may appear in the urine. Severe pain may alternate with relief over several days. During acute pain, a person may even feel when a kidney stone is passing. Depending on what the symptoms of kidney stones are, severe or mild, you should definitely consult a doctor.

Treatment

Doctors determine treatment for kidney stones based on the size of the stone and general condition sick. If the stone is large, it is removed through surgery. The operation is also carried out when renal failure patient, purulent pyelonephritis, or obesity. Other treatments include medication, laser crushing of stones, and traditional medicine, or surgical intervention.

The doctor may prescribe drug treatment if the composition and size of the stone are identified, if inflammatory kidney diseases are determined in the patient and when the size does not exceed 0.5 cm. Also, during treatment it is necessary to adhere to special diet. Proper nutrition is as follows: you should limit the consumption of table salt and animal protein, and be careful with products containing oxalic acid and calcium. It is advisable to drink at least 2 liters of liquid per day, and you also need to eat foods rich in proteins. If you follow these simple measures, you can facilitate the removal of kidney stones.

Splitting up

If the size of the stone exceeds 0.5 cm, then it is removed by ultrasonic crushing. In some cases, stones may pass out of the kidneys on their own. If the stone moves into the ureter, the pain spreads to bottom part abdomen and groin area. When the most severe attack of pain occurs, there is a possibility that the stone came out on its own along with the urine. But it also happens that a stone, no matter its size, sits securely in the kidney and is not going to come out, then in this case surgery is required. If the size of the stone is from 1.5 to 2 cm, then crushing stones with ultrasound is the most effective method treatment. Ultrasound is used to accurately detect their location. After this, a small incision is made in the kidney area and a nephoscope is inserted, with the help of which ultrasound crushing is carried out. Then the fragments are carefully removed. The operation is performed under general or spinal anesthesia.

dolgojit.net

Mechanism of disease development

The main function of the kidneys is to eliminate toxins. Often they are not completely excreted, but crystallize and over time turn into kidney stones, usually containing calcium, less often protein or uric acid. Some formations are capable of being excreted independently in urine, but only if the kidney stones are no larger than 7 mm in size. Reaching 1 cm, they linger in the organ. This often results in intense pain in the form of renal colic. It happens that the stones have not completely left the organ and are stuck, then complete or partial urinary retention occurs, and the patient needs urgent surgical intervention.

If you ignore treatment, the stones can increase in size: this is due to the individual tendency of the body to form them and how accurately the diet and drinking regime are followed.

At first resembling a grain of sand, the calculus gradually grows to 1.5 cm or more. After the formation of the stone ends, it begins its movement towards the exit. This may take about a month. However, often the stones do not pass out on their own, and then, in the absence of adequate therapy, there are more and more of them in the organ. As a result, everything leads to the fact that the patient risks losing his kidney.

Localization of stones is possible in any part of the urinary system: calyces, renal pelvis, ureter, urethra, bladder. As a rule, the formation of stones occurs in one kidney, but occasionally it occurs pathological process in both.

As for the structure, the stones are:

phosphate - with phosphoric acid;
oxalate - with oxalic acid;
urate - with urea and salts;
carbonate - with carbon dioxide;
cystine - with a sulfur compound;
struvite (infectious);
protein - with fibrin, bacteria and salts;
mixed - with minerals and organic matter;
cholesterol;
uric acid - with salts of uric acid.

Consistency and sizes

When the physicochemical composition of the blood in the kidneys is disturbed, amorphous salts and crystals precipitate. They are joined by organic matter in the form of blood clots, bacterial flora, fibrin, cellular detritus, etc. As a result, stones are formed.

Mostly oxalate stones appear in the kidneys, which contain oxalate and calcium salts; quite often the formation of phosphate and urate stones occurs, less often cystine stones.

Concretions are formed both single and multiple. In some patients kidney stone for a long time does not grow and does not move, in others the crystal becomes half a centimeter in six months and is excreted in the urine, in others the stones quickly increase in size and lose the ability to pass without surgery, and in the fourth, after removal of stones, relapses constantly occur.

Symptomatic manifestations

Until the stones begin to move into the ureter, they do not bother the person in any way. But as soon as they begin to move, the following symptoms arise:

painful urination;
pain in the lower back;
groin pain;

urine turns red, pink, or brown;
feverish condition;
vomit;
feeling of a full bladder.

If the patient is bothered by pain that does not allow him to move calmly, if he feels nauseous and vomiting, if chills and fever appear, then it is necessary to immediately see a specialist.

Principles of treatment

Depending on the size of the formation (and this is determined during examination by ultrasound, CT or MRI), the treatment method is determined:

If the stone is small, up to 7 mm, then herbal preparations are used. This could be Phytolysin, Canephron or medicinal herbs - half-half, knotweed.
Concretions larger than 7 mm are destroyed and crushed into smaller ones.
If the stone is large (1 cm or more), then it is removed surgically.

Method 1 is safer and more gentle. If the doctor is experienced and the patient strictly follows all the recommendations, then the stone will come out on its own.

However, we must remember that if stones larger than 7 mm are removed with the help of medications, they can get stuck in the ureter, and the patient will develop an attack of renal colic. You also need to understand that medications should only be prescribed by a doctor; if you self-medicate, you can worsen your condition and cause various complications. So, the list of medicines:

Prolit and Cyston - prescribed for the purpose of dissolving and removing oxalate stones;
Urolesan - relieves spasms by dissolving small stones;
Allopurinol - reduces the density of uric acid;
Canephron - fights inflammation and bacteria, relieves spasms, has a diuretic effect, provokes the removal of stone fragments;
Blemaren - used for removing mixed type stones;
Asparkam – dissolves stones of phosphate, uric acid, calcium and salt origin;
Xidifon - prescribed if there are phosphate and oxalate formations;
Madder dye (extract) – used for phosphate stones, it is prohibited simultaneous use with Cyston.

To make the stones pass more painlessly, you must follow the drinking regime prescribed by the doctor. Stones passed with urine should be provided to a specialist for examination.

Crushing is carried out using a puncture or contact method. A puncture is made in the lumbar region, and a nephroscope - a metal tube - is inserted into it. The doctor inserts instruments into the nephroscope to crush and remove stones. This method is used if 1 large stone is diagnosed, which cannot be removed with medications.

If contact removal is performed, the instrument is inserted into the urinary canal.

Crushing is performed only when the formation is small, since large fragments can block the renal lumen.

Stones are also crushed using shock wave lithotripsy, which is indicated for patients with stones ranging from half a millimeter to two and a half millimeters. With this gentle method, no puncture is made. Concretions are destroyed by radio waves.

The surgical method for removing stones can be endoscopic or laparoscopic. Complications with this type of operation are negligible, and the recovery period is short. Currently, the operation excludes a kidney incision; all instruments are inserted through the urinary canal or urinary cavity.

Such an intervention is carried out if it is not possible to remove the stone with medications or crush it, or when it is very large.

For stones larger than 2 cm, abdominal surgery is performed. This traumatic method is associated with a large number of complications, since during the intervention, an incision is made in the kidney and stones are removed from it.

Preventive measures

If a patient is diagnosed with sand in the kidneys, it is very important to follow the following recommendations:

The volume of liquid drunk per day should be at least 2 liters. In this way, salts and sand will be removed from the kidneys, and the urine will become clear and odorless. In hot weather, you should try to drink 0.5 liters of water every hour.
Diuretic foods, such as watermelon and cucumbers, should be included in the diet.
At least 2 hours a day should be allocated for walking.
In the cold season, the lumbar region must be insulated. Hypothermia can lead to inflammation of the kidneys and the appearance of urolithiasis.

To protect yourself from genitourinary infections, it is advisable to use protection during intimacy. And in the case of unprotected sexual intercourse, immediately after its completion, you must urinate, so the infection will come out with a stream of urine.
Should be adhered to dietary nutrition. It is not recommended to abuse strong tea, coffee, cocoa and chocolate.
Drinking water must be free of salts and metals.

People who have a tendency to form stones need to regularly visit a nephrologist and begin treatment until the stones become so large that it is impossible to remove them with medication. Be healthy!

Formations are formed as a result of accumulation in paired organ uric, phosphorus, oxalic salts. Over time, they begin to thicken and grow. This happens under the influence of various factors: poor nutrition, Availability bad habits etc. Kidney stones can vary in size. The urinary tract has a diameter of up to 0.8 cm. Therefore, in some cases, stones are removed surgically so as not to block the passage. Treatment is prescribed by a specialist depending on the size of the kidney stones.

Symptomatic manifestations

Symptoms of formations less than 6 mm:

Blood and sand in urine;
Cloudy urine;
Constant “small” trips;
Pain and pain during urination;
Increase in temperature;
Feeling of nausea and vomiting;
Pain in the abdomen, lumbar region;
A person is thrown either hot or cold.

The greatest pain occurs if formations are present in organs on both sides.

Consistency and sizes

Often, patients who have been diagnosed with stones in a paired organ are interested in what size of kidney stones is considered the most unfavorable in the world. The biggest and dangerous stone in the kidneys it can reach 25 mm. Such formations are considered life-threatening. They are also:

Formations 0.1-0.2 cm;
3 mm;
4-5 mm;
6 mm;
Size 7 mm;
8 mm-1 cm;
Coral 11 mm, 12 mm, 13 mm;
Formations 14-15 mm, 16 mm-18 mm;
Corals in bud 2 cm (centimeter), 1.9 cm;
Education 2.1-2.5 cm.

If a kidney stone up to 5 mm has formed, the doctor decides what to do with it. Such a small calculus is usually removed with conservative therapy. If corals of 25, 9, 17 mm, etc. are formed. (more than 5 mm), they usually resort to surgical intervention. Kidney defects cannot be treated on your own. Therapy should be carried out under the supervision of a physician.

Treatment methods

Patients are often interested in how large a stone can pass on its own. As a rule, formations up to 0.5 cm are eliminated without problems. However, they need to be helped with this with conservative therapy:

Balanced diet;
Maintaining water and electrolyte balance;
Taking medications;
Phytotherapy;
Physiotherapy;
Sanatorium-resort holiday.

How to get rid of stones is determined by the doctor after diagnostic measures. They are usually brought out an integrated approach. It is necessary to undergo treatment. Otherwise, formations may cause adverse consequences. The genitourinary system will stop working normally.

You can also eliminate small formations traditional methods. You just need to use them correctly. Before removing stones at home, consult your doctor. Traditional methods treatments are not suitable for everyone.

Surgery

Surgery is resorted to when corals in the right or left pelvis with a diameter of more than 5 mm. Stones measuring 0.6 centimeters or more are eliminated using the following methods:

Open operational influences. Old and reliable way. However, it is traumatic and therefore dangerous. The formation is eliminated through an incision in the paired organ or bladder. Prescribed only in extreme cases;
Endourethral technique. Endoscopic equipment is introduced into the pelvis through the urethral canal or a puncture in the skin. The device is brought to the stone, which is removed using a laser beam, mechanically, or ultrasound.

During the preparation for surgery, antibiotics and antioxidants are prescribed. Medicines are also prescribed to normalize the circulation of blood fluid.

Crushing stones

Shock wave lithotripsy is the crushing of stones in the renal calyx (pelvis). In this way, large stones up to 20 mm can be removed. This technique is popular because it does not require punctures or incisions in the skin. Corals are affected remotely by waves. After this, the natural release of finely crushed formations occurs.

For the procedure can be applied different kinds remote lithotripter. Shock wave lithotripsy is not suitable for every patient. The procedure has contraindications. Before undergoing it, you should consult a doctor.

Drug treatment

Drug therapy is aimed at stopping the growth of formations and dissolving them. Also, the use of medications can remove kidney stones. Usually prescribed:

Canephron N. Plant-based. Prescribed for urate, calcium oxalate corals;
Cyston. Herbal remedy. After its use, the corals emerge from the buds on their own. Prescribed for any type of formation;
Blemaren, Uralite U. Dissolves urate and mixed stones. Alkalinizes urine;
Phytolysin, Phytolit. Prescribed for small corals. Prevents their growth and the emergence of new formations.

When pathological condition is infectious in nature, additional antibacterial medications are prescribed.

Urolithiasis is quite common, due to poor quality nutrition and an unhealthy lifestyle. Today, there are many ways to treat stones both surgically and medically. The treatment method depends on the size of the stone. What are the types of stones and what should the patient do?

The process of occurrence and types of stones

Kidney stones most often consist of calcium, but sometimes they may contain uric acid or proteins.

With small sizes up to 5-7 mm, the stone can pass out of the kidney along with urine. But if its size reaches 10 mm, then it remains in the kidney and can cause complex renal colic, which causes severe pain. If a stone gets stuck at the exit of the kidney, then complete urinary retention occurs. In this case, immediate surgical intervention is required.

Almost all stones up to 5 mm in size can pass out on their own in the urine; about half of kidney stones ranging in size from 5 to 10 mm also pass out without additional intervention from doctors (antispasmodics and diuretics are used).

Once formed, the stone may pass within three weeks or within a month after the first symptoms appear.

Prevention

Patients with sand in the kidneys should adhere to the following recommendations:

Drink more than 2 liters of fluid per day. In this case, the kidneys will be well cleaned of sand and all accumulated salts. The urine will become clear and odorless. In summer, when there is intense heat, it is recommended to carry out special procedures to cleanse the kidneys. You need to drink half a liter of water at a time or a liter in 30 minutes. Cleanse the kidneys. consuming diuretic products. So, watermelon has a diuretic effect. Take long distance walks daily. It is recommended to walk in the fresh air for at least two hours. Don't get too cold. In cool weather, the lower back should always be kept warm, because hypothermia can provoke inflammation of the kidneys, and as a result, urolithiasis. Use protection during sexual intercourse. In order to prevent infection with genitourinary infections, because the infection can spread to the kidneys, if the act was not protected, it is necessary to urinate after it. Follow a diet. You should not consume chocolate, cocoa, coffee and strong tea in large quantities. It is useful to drink decoctions of diuretic herbs. It is advisable to drink purified water. From heavy metals and salts (filtered or bottled).

But it is not always possible to prevent the onset of the disease with the help of prophylaxis, especially if the patient already has large stones in the kidneys. What to do, how to treat stones of small, medium and large sizes?

Treatment methods

Depending on the size of the stones, as well as the patient’s health condition, the following treatment methods are available:

Phytotherapy. The use of herbal preparations helps not only to get rid of inflammation, but also to dissolve stones up to 5-7 mm in size. They use Canephron, Phytolysin, as well as knotweed and half-fallow herbs. Destruction and crushing of stones. Surgical removal.

Surgery

Surgical treatment is carried out endoscopically or laparoscopically. The recovery period, as well as possible complications after these types of operations, are minimal. Surgical intervention is performed without incision of the kidney and skin; the instrument is inserted through natural routes: the lumen of the urethra, the bladder cavity, the ureter and the kidney.

Surgery is performed in cases where it is not possible to dissolve or crush the stone or it is large in size.

If the stone grows more than 20 mm, then open surgery is performed. This type of surgery is very traumatic and has many complications. During this type of operation, the kidney is cut and all contents are removed.

Crushing stones

The destruction of stones can be done by contact or through a puncture.

When destroyed surgically, the stones are removed using a special metal tube - a nephroscope. It is inserted through a puncture in the lumbar region. Various crushing and removal instruments can be inserted through the nephroscope. Most often, this method is used if the patient has only one large stone that cannot be dissolved with medications.

In addition, there are laser, ultrasound, electrohydraulic and pneumatic lithotripsy.

Drug treatment

If the stone is up to 5-7 mm in size, then it is amenable to a non-operative treatment method, namely medicinal dissolution. This method is the safest and most gentle. If everything is done correctly, the stone will come out on its own.

For medical dissolution the following drugs are used:

Canephron. It has anti-inflammatory, antibacterial, diuretic and antispasmodic effects. Promotes the removal of stone fragments. Asparkam. Promotes the dissolution of salt, uric acid, calcium or phosphate stones. Madder extract. Used to dissolve phosphate stones. It cannot be used simultaneously with Cyston. Urolesan. Dissolves urinary stones and relieves spasms. Xydiphone. Used to dissolve phosphate and oxalate stones. Blemaren. A very effective drug for getting rid of mixed type stones. Allopurinol. Helps reduce the concentration of uric acid in urine. Cyston or Spill. Suitable for dissolving oxalate stones.

It is worth remembering that all medications should be used only as prescribed by a doctor, because self-medication can lead to a deterioration in health and ending up on the surgical table. The urologist will help determine the type of deposits and select the appropriate drug.

When dissolving (removing) stones larger than 5-7 mm with the help of medications, it may become stuck in the ureter, which will provoke an attack of renal colic (you need to be prepared for this and know what needs to be done if an attack occurs).

Causes of pathology

1Lack of water. If you don't drink enough water or other liquids per day, you may become dehydrated, which makes you more likely to develop kidney stones. It should not be ruled out climatic conditions- in particularly hot countries, the amount of fluid consumed per day should increase. 2Kidney diseases. Often, kidney disease becomes chronic over time. Such diseases may include cystitis and pyelonephritis. Congenital kidney diseases can also play a significant role in the formation of stones. This type of disease includes salts in the kidneys. Over time, salts turn into stones - this mainly concerns urate salts. Too much calcium in the human body can also lead to the formation of kidney stones. Often, a disease such as gout leads to the formation of stones. 3Very often, poor nutrition becomes one of the causes of the formation of kidney stones. Excessive consumption of foods containing calcium can lead to the disease. Fatty foods, large amounts of salt and animal protein can also affect the formation of kidney stones. 4Sedentary work also leads to kidney stones. This is due to the fact that a sedentary lifestyle and long stay a person in one position can lead to stagnation in the pelvis, and this, in turn, leads to the formation of urolithiasis. Expert opinion: Today this is one of the most effective means in the treatment of kidney diseases. I have been using German drops in my practice for a long time...

An effective way to cleanse your kidneys at home

Symptoms of kidney stones

The main symptoms of kidney stones include the following: dirty-colored urine, sand and blood in the urine. With kidney stones, the patient, as a rule, often goes to the toilet, and urination is accompanied by very strong and cutting pain. Patients often experience sharp pain in the abdomen and lower back, along with this there is an increase in temperature, nausea and vomiting, the patient feels either hot or cold.

Treatment methods

With plenty of fluid intake, many stones can pass out on their own through the urinary tract. These stones include stones ranging in size from 4 mm to 6 mm. If the kidney stone is 7 mm or more, then medical intervention is required to remove it. Doctors often prescribe the drug Biliurin to remove kidney stones. With the help of this remedy, the stone decreases in size and is gradually removed from the body. Often surgery may be required to remove a kidney stone.

Surgery is required if the stone is too large - 10 mm or more, and its growth does not stop, but continues to increase. If the patient experiences very severe pain during the removal of stones and this pain cannot be relieved, a decision is made to remove the stone surgically. The operation is also prescribed in case of obstruction of urine from the urinary tract, when the passage is blocked by a stone.

There are several types of operations to crush and remove kidney stones:

1Treatment with laser lithotripsy. This type The operation is designed to crush small stones, for example, with a diameter of 6 mm. The stone is crushed using a laser or ultrasound and then in the form of sand is independently excreted from the body along with urine. 2Percutaneous nephrolithotomy. This type of surgery is performed when large stones. The patient makes a small incision through which an endoscope is inserted, and with its help the stone is removed from the kidney. 3Uretroscopy. This operation is prescribed if a stone has passed out of the kidney and is stuck in the urinary tract. The intervention is performed using a urethroscope. Using this device, you can not only conduct a thorough examination, but also perform the necessary operations.

Folk remedies

Treatment with folk remedies. Such remedies will be effective if kidney stones do not exceed 6 mm:

1Infusion of geranium. Dried and crushed leaves and flowers of geranium should be infused for 9-10 hours in 2 glasses of boiled and cooled water. Then the finished infusion should be strained and drunk in small sips throughout the day. This remedy can not only dissolve kidney stones - it is also very effective in other kidney diseases, diarrhea, gout and rheumatism. 2 Treatment with syrup from rowan juice. To prepare this juice, you need to take one kilogram of fresh rowan, rinse and dry it thoroughly and squeeze out the juice. Then you need to cook all the resulting juice with 500 grams of sugar until it is completely dissolved. 3 Herbal infusion. Take dill, burdock and blueberry leaves, chicory herb in equal quantities, dry, chop and mix well. Take 1.5-2 tablespoons of the resulting mixture and pour 0.5 liters of boiling water. Infuse for 8-9 hours and drink one quarter glass several times a day. The course of treatment with this infusion is at least 2-3 months. 4 Herbal infusion. Take the same amount of lingonberry leaves, St. John's wort, sweet clover, motherwort and madder root - wash it all, dry it, chop it and mix it. Place two tablespoons of the mixture in half a liter of boiling water and leave overnight, wrapping it in something warm. Take 0.5 cups 2-3 times a day. 5 Collection of herbs. Take equal parts of meadowsweet, knotweed, immortelle leaves and bearberry. Dry all this, chop finely and mix. Then put 3-4 teaspoons of the prepared collection in half a liter of boiling water and leave for 8-10 hours. Drink half a glass several times a day. 6Treatment with a decoction of medicinal herbs and wine. Grate 150 grams of horseradish root, add 3 tablespoons of dried and finely chopped knotweed, add 6-7 tablespoons of honey, pour red wine over the resulting mixture and leave in a cool, dark place for 3-4 days. After this, cook over low heat until it boils, cool, strain and consume 50-100 ml. before eating.

Special diet

If a patient has calcium and phosphorus stones in his kidneys, he should take at least 2.5-3 liters of fluid per day. At the same time, do not forget that you should not consume milk, dairy products and fish dishes. In the case of oxalates, the amount of fluid you drink should be two or three liters per day. Should be excluded from the diet following products: dairy products, chocolate, berries, strong tea.

With urate stones, the amount of fluid consumed per day is 2-3 liters per day. As for food, you should not consume all types of fried and smoked meat, fatty meat broths, seafood, seasonings and any alcoholic products.

It is not necessary to drink only mineral or filtered water - it can be replaced with cranberry or lingonberry fruit drinks.

Preventive actions

It is known that urolithiasis is mainly chronic, and there is a high probability of recurrence of kidney stones. In order to avoid this, you need to follow all the instructions of your doctor: follow a diet, take all prescribed medications on time, observing the exact dosage. In addition, in no case should you forget to drink plenty of fluids - a person should drink at least 17 glasses of water per day. It is important to remember that the water should be either filtered or mineral without gas, since ordinary water can contain a large accumulation of salts and sand: if the water is not purified, all this can settle in the kidneys.

Frequent urination? Decreased potency due to prostatitis? Everything will pass in 3 days, if you take...

A good preventative measure can be regular intake of decoctions of diuretic herbs: corn silk and St. John's wort. Rose hips have a very good diuretic effect, which should be infused in boiled water for several hours. This infusion can be used instead of tea.