Urolithiasis disease (уролитиаз) – заболевание, возникающее в
the result of metabolic disorders, in which the urine is formed
insoluble sediment in the form of sand (up to 1 mm in diameter) or stones
(from 1 mm to 25 mm and more). Камни оседают в мочевыводящих
pathways that disrupt the normal flow of urine and cause
the occurrence of renal colic and inflammation.
What is the cause of urolithiasis, which are the first
signs and symptoms in adults, and what is prescribed as
treatment, consider next.
What is urolithiasis?
Urolithiasis disease — это заболевание, характеризующееся
appearance in the urinary organs (kidneys, ureters,
bladder) solid stone-like formations. Inherently
urinary stones are crystals that originate from salts,
dissolved in urine.
Concretions in urolithiasis may be localized as in
right and left kidney. 15-30% of patients have
double-sided stones. Clinic for urolithiasis is determined
the presence or absence of violations of urodynamics, changes in renal
functions and affiliated infectious process in
ATиды мочевых камней:
- Ураты — камни, состоящие из солей мочевой кислоты,
yellow brown, sometimes brick-colored with smooth or slightly
rough surface, rather dense. Formed during acidic
- Фосфаты — конкременты, состоящие из солей фосфорной
acid, greyish or white, unstable, easily broken,
often combined with infection. Formed in alkaline urine.
- Оксалаты — состоят из кальциевых солей щавелевой кислоты,
usually dark, almost black with a spiky surface,
very dense. Formed in alkaline urine.
- Редко встречаются цистиновые, ксантиновые, холестериновые
- Смешанные камни — самый распространенный вид
This disease is polyetiologic, that is, to its
development leads to several factors. Most often urolithiasis
the disease develops in people aged 20–45 years, with men
suffer from it 2.5-3 times more often than women.
Urolithiasis disease развивается, чаще всего, из-за нарушения
metabolism. But here it is necessary to take into account the fact that urolithiasis is not
будет развиваться, если для этого нет предрасполагающих
The causes of urolithiasis are as follows:
- diseases of the kidneys and urinary system;
- metabolic disorders and diseases associated with it;
- pathological processes of bone tissue;
- chronic diseases of the digestive tract;
- unhealthy diet, excessive consumption of junk food –
spicy, salty, sour, fast food;
- acute lack of vitamins and minerals.
Stones with urolithiasis can form in any
отделе urinary tract. AT зависимости от того, где они
are, distinguish the following forms of the disease:
- Nephrolithiasis in the kidneys;
- Ureterolithiasis – in the ureters;
- Cystolithiasis – in the bladder.
Symptoms of urolithiasis
The first signs of urolithiasis are found either
by chance, during the examination, or during a sudden
renal colic. Renal colic – severe painful attack, often
which is the main symptom of urolithiasis, and sometimes
the only one that results from a spasm of the urinary duct,
or its obstruction by stone.
ATедущие симптомы мочекаменной болезни, или на что жалуются
- жжение и резь над лобком и в мочеиспускательном канале при
urination – due to spontaneous emergence of small
pebbles, the so-called “sand”;
- low back pain associated with a sharp change in body position,
shake violently, drink plenty of water (especially after drinking
liquids such as beer and brines). Pains are due to
slight displacement of stones;
- hyperthermia (high temperature) – indicates
severe inflammatory reaction to the stone at the place of its contact with
mucous membranes, as well as the accession of infectious
- Renal colic. When blockage of the ureter stone pressure
in the renal pelvis rises sharply. Stretching the pelvis in the wall
which is a large number of pain receptors, causes
severe pain Stones less than 0.6 cm in size, as a rule, depart
on their own. With narrowing of the urinary tract and large stones
The obstruction does not spontaneously disappear and may cause
damage and death of the kidney.
- Hematuria. In 92% of patients with urolithiasis after
renal colic is marked microhematuria, resulting from
damage to the veins of the fornical plexus and detected during
And the size of the calculus is not always comparable to the severity
complaints: the largest stones (coral stone) can
for a long time not to disturb a person, whereas relatively
a small calculus in the ureter leads to renal colic with
severe pain manifestations.
Clinical manifestations depend primarily on localization
stone and the presence or absence of inflammatory process.
Signs of urolithiasis with localization in different
|Localization of stones||Symptoms|
|Bladder||The severity of the area:
Frequent and difficult urination, which is accompanied by
|Ureter||Sensation that the bladder is not completely emptied. Pain in
area of the genitals, thighs and groin
zone of the abdomen, which can give in the crotch and lower
Extremities Nausea prone to repeated vomiting
With the development of the pathological process can be observed
such signs of urolithiasis:
- unstable blood pressure;
- increased body temperature, sometimes up to 40 degrees;
- симптомы почечной колики;
- frequent urination that does not bring
- pain in the lumbar region, sometimes on both sides;
- blood in the urine;
- pain when urinating.
Common complications of urolithiasis:
- Chronic inflammation in the area of the calculus,
выраженное пиелонефритом, уретритом или циститом, которые
against the background of negative influences (viral diseases, hypothermia)
go into acute form.
- Chronic pyelonephritis that progresses rapidly to
- Acute inflammation of the kidneys can be aggravated by paranephritis with
the appearance of pustular organ tissue lesions. AT дальнейшем
probable abscess and blood poisoning, which is a direct indication
to surgical intervention.
- Ishuria, or acute urinary retention.
- Pyonephrosis is a serious complication of purulent pyelonephritis,
characterized by the destruction and melting of kidney tissue.
- Anemia occurs as a result of permanent blood loss from
If you suspect urolithiasis, you must first contact
to the therapist who will conduct the initial examination of the patient.
If stones are found in the kidneys, the patient will be sent to
nephrologist, if in the bladder – to the urologist. AT лечении участвует
a dietitian and also often require prompt
Diagnostics мочекаменной болезни основывается на следующих
- Characteristic complaints of the patient to recurrent back pain,
bouts of renal colic, urination disorders.
- General and biochemical analyzes of urine and blood.
- Excretory urography (introduction of a contrast into the blood,
which is excreted in the urine unchanged).
- Retrograde pyelography (introduction of contrast in the direction,
reverse flow of urine through the urethra). Produced rarely and strict
- Special blood tests for parathyroid hormone and
calcitonin, calcium and magnesium salts, determination of blood pH.
- CT scan.
From what stones are formed in the kidneys with urolithiasis
disease, will depend on the selection of treatment. In order to determine
type of stone, it is enough to pass the tests:
- анализ крови на кальций (ионизированный и
общий), фосфор, магний, мочевую кислоту;
- общий анализ мочи;
- biochemical analysis of daily urine for urates, oxalates, calcium
- stone spectral analysis – gives the most accurate information about
Based on the research results, the doctor will determine which type of
salts prevails and what is the stone.
Both operational methods of treatment and
conservative therapy. Tactics of treatment is determined by the urologist in
depending on the age and general condition of the patient, localization and
the size of the stone, the clinical course of urolithiasis, the presence
anatomical or physiological changes and renal stage
General principles of treatment of urolithiasis:
- Drink plenty of water. Whatever the reason
the emergence of ICD, concentrated urine contributes
the formation of new stones or the “growth” of existing ones. AT случае
Nephrolithiasis recommended at least 2 liters of fluid for
- Diet. AT зависимости от характера рН и преобладающих солей
prescribed a diet that promotes the dissolution of small stones. Diet
питания может или ускорять их растворение, или способствовать
their formation and recurrence of ICD even after the stone is released.
- Physical activity. Immobility, sedentary lifestyle
provoke the occurrence of stones, and walking, running, jumping – removing
- Фитотерапия: мочегонные, противовоспалительные травы.
- Удаление камня (хирургическими и консервативными
Medications for urolithiasis:
- Anti-inflammatory: indomethacin, ibuprofen, acetomenophen,
- Antibacterial: cilastatin, gentamicin, amikacin,
- Antispasmodics: drotaverine, mebeverin, otiponiya bromide;
- Analgesics: voltaren, revodin, diclomax;
- Diuretic: furosemide, aldactone, veroshpiron
- ATитамины: группы AT.
Indications for surgery for urolithiasis:
- large sizes of stones when they cannot be crushed and
withdraw without surgery;
- significant impaired renal function, while the rest
treatment methods in this case are contraindicated;
- the position of the stone: if it is inside the kidney, its very
difficult to crush and take out;
- purulent process in the kidneys (purulent
Types of surgery:
- Endoscopic removal of stones from the bladder and end
Department of the ureter.
- Laparoscopic kidney or ureter surgery.
- Extended open kidney surgery (performed upon
large kidney stone when resection is required or
- Lithotripsy. Destruction of stone focused
electro-hydraulic wave. The destroyed calculus is displayed with
urine in the form of sand.
Depending on the type of urinary formations and identified exchange
violations by the doctor prescribed nutrition for urolithiasis. AT
The whole diet for urolithiasis includes:
- increase fluid intake (at least 2 liters per day);
- decrease in volume of portions;
- increase in dietary foods rich in fiber;
- restriction of salt intake, spices;
- restriction of the use of food and drinks with stone-forming
properties (animal protein, purines, oxalic acid, etc.).
What can not eat with different types of urolithiasis?
Nutrition for kidney disease will depend on the composition
stones, and therefore may include mutually exclusive products.
Calcium is the basis of most urinary stones. Celebrated
the highest prevalence of calcium stones (among which
calcium oxalate and calcium phosphate), urate, consisting of
uric acid salts and magnesium-containing. Main role in
the formation of calcium oxalate plays a glut of urine with calcium and
Лечебная диета при отложении оксалатных камней
provides an exception to the power supply:
- green lettuce, spinach, sorrel, rhubarb, beets, celery,
- chocolate, cocoa;
- jelly and jellies;
- figs and portulaca;
- vitamin C as a dietary supplement, as well as products where
vitamin is a preservative;
- smoked meat, salinity and pickles;
- broths and spices;
Запрещенные продукты при отложении уратных камней:
- canned marinades;
- fish and meat of adult animals (you can eat three times a week not
fatty varieties in boiled form), veal and
- sausages and smoked meats;
- offal (brain, liver, lungs);
- salted cheese;
- animal fats (pork, beef, or cooking);
- a fish;
- sorrel and spinach, cauliflower, rhubarb and figs;
- rich broths, including mushroom;
- alcoholic beverages (especially beer and red wine);
- tea and coffee (sometimes you can not strong), cocoa and chocolate,
When phosphate stones from the diet are temporarily excluded:
- foods rich in calcium: dairy products, eggs,
- salty and spicy foods (salt limit up to 8 g per
- garden greens (lettuce, green onions, dill, parsley, leaves
celery and cilantro);
- орехи, cocoa;
- sweet pastry (biscuit, cakes, pies);
- fruit juices;
Before using any folk remedies, you need a mandatory
consultation with your primary care physician. Because in the presence of large
stones, possible serious consequences.
AT основном, применяются различные травяные сборы, вид которых
is selected depending on the chemical composition, size and
localization of stones. AT состав лекарственных сборов могут входить
The following medicinal plants:
- corn silk;
- burdock root;
- dog rose;
- tricolor violet;
- dandelion roots;
- grape leaves;
- currant leaves, etc.
Preventive methods of urolithiasis consist of
- sufficient physical activity;
- weight loss to optimal performance;
- restriction of the use of alcoholic beverages;
- prevention of stressful situations;
- expansion of the drinking regimen to 2.5–3 l during the day;
- restriction of the use of animal proteins, their
substitution of plant.
If you have urolithiasis, be sure to
начинайте лечение только после согласия врача. Self-medication
can lead to serious complications for the whole body. Be