Urolithiasis - symptoms and treatment, renal colic, diet. Urolithiasis: symptoms and treatment

Among all urological diseases, urolithiasis is considered the most common. It can be diagnosed in adults and children, develop as an independent disease or be the result of other pathologies occurring in the human body. In urology, the term "urolithiasis" refers to a group of diseases in which stones (calculi) form in the kidneys or the urination system. Such formations can have different sizes, shapes, localization, manifest a pronounced clinic or do not bother a person for a long time.

When stones or sand appear in the kidney parenchyma, its pelvis or calyces, patients are often diagnosed with "nephrolithiasis" or nephrolithiasis. The etiology of the disease is a combination of factors that in one way or another affect metabolic processes, the functioning of the kidneys and the genitourinary system. With prolonged inflammation in the tissues and structures of the urination system, the risk of calculus formation increases tenfold. Before considering the reasons why kidney stones appear, it is important to know the symptoms and treatment, how dangerous the disease is and its classification.

Urolithiasis (ICD) or urolithiasis is a chronic disease in which urinary tract is formed. Localization of formations can occur anywhere in the urinary system, affect the urethra, bladder, ducts, or structure of the kidneys. The frequency of occurrence is about 30 - 40% of all urological pathologies. Basically, the pathology affects people from 30 to 50 years old, but can also occur in children. Statistics show that men are 3 times more likely to suffer from this disease than women. With kidney stones, the symptoms directly depend on the location, size of the formations, as well as their number.

Sometimes, the clinic is absent and appears only when the stones increase in size, put pressure on other organs, or cause congestive processes. With urolithiasis, there were cases when, even with minor kidney formations, the patient complained of severe symptoms.

Kidney stone disease or nephrolithiasis refers to polyetiological pathologies, so it is not always possible to recognize the true cause. It is a fact that KSD develops in violation of metabolism against the background of inflammatory processes in the genitourinary system, chronic diseases of infectious or non-infectious origin.

Development mechanism

The process of stone formation in ICD occurs against the background of a violation of urodynamics, when for some reason the outflow of urine is disturbed. In this condition, the excretion and resorption of urine elements are disturbed, the salt precipitate crystallizes, which creates favorable conditions for the development of the inflammatory process, followed by the formation of stones.

The disease begins with the formation of a center or core of calculi, on which salts gradually settle. Depending on the precipitation of salts, the rate of their settling, a stone is formed, which can have different sizes, from microscopic to 10 or more centimeters. Small stones, sand are often removed on their own, do not cause severe symptoms. Formations of medium or large sizes are not independently excreted, but can move along the urinary tract, damage the walls of the ureter, provoke congestive processes or reflex spasm of smooth muscles. With such violations, the excretion of urine is blocked, the patient begins to experience a pronounced clinic.

Often the pain is so severe that the patient is forced to seek emergency medical care.

When pressure rises in the area of ​​the renal pelvis, there is a blockage in the urinary tract, an attack develops. Severe and acute pain is explained by the presence of pain receptors in the pelvis, which react sharply to tissue stretching, which causes acute pain syndrome.

Crystal salts are insoluble during the development of urolithiasis, they are able to settle in the bladder, kidneys or urinary canals, after which they disrupt their work, provoke inflammation, and the growth of the formations themselves. KSD refers to multifactorial pathologies, which has several types, classifications, therefore, before treatment, you need to undergo a comprehensive examination, determine the localization of formations, their size, composition and other indicators.

Classification

The classification of urolithiasis consists of several indicators, which include the causes, types, nature and composition of the formations themselves.

By composition, the stones are divided into:

1. Inorganic.
2. Organic.
3. Mixed.

In count:

1. Single.
2. Multiple.
3. Coral.

By localization, stones may be present in:

1. calyx.
2. pelvis.
3. Ureter.
4. Bladder.
5. Urethra.

Due to occurrence:

1. Primary.
2. Recurrent.
3. Residual.

By the nature of the flow:

1. uninfected;
2. Infected.

To size:

1. Small - from a few millimeters (sand).
2. Medium - from 1 cm to 3 cm.
3. Large - from 4 cm to 10 and more centimeters.

By form:

1. Flat.
2. Smooth.
3. Angular with sharp edges.

Causes and risk factors

Despite the possibilities of modern urology and nephrology, the exact causes of KSD are unknown, but still all doctors unanimously claim that this pathology is directly related to metabolism. It is in violation of metabolic processes in the pelvic organs that the formation of insoluble salts occurs, which over time are converted into stones. According to statistics, in 75% of cases there are oxalate stones, less often phosphate and urate. Most often, the causes of urolithiasis are hidden in violations of the genitourinary system, less often the disease develops as an independent disease.

Regardless of the etiology of the disease, it is necessary to treat KSD under the supervision of a urologist, who will collect an anamnesis, prescribe the necessary series of tests for urolithiasis, which will help determine the form, stage, localization, size and other indicators. With the development of urolithiasis, the causes are often associated with a person's lifestyle, nutrition. In men, an attack can occur after alcohol abuse, and in women, against the background of hormonal changes.

Clinical signs of the disease

The clinic of urolithiasis is quite diverse, depending on the location, size of the stones, concomitant diseases. Sometimes the disease may not bother a person for several years, manifested by minor disturbances in the functioning of the genitourinary system. The asymptomatic course of the disease suggests that the stones do not increase in size, do not significantly affect the functioning of the genitourinary system. More pronounced manifestations are present when the stones become medium or large in size. Then the signs of urolithiasis have clear and prolonged symptoms. The patient complains of constant or recurrent pain in the lumbar region, urination is disturbed, there is a general intoxication of the body and a significant deterioration in general well-being.

An exacerbation of urolithiasis may appear on the background of drinking alcohol or eating "forbidden foods." Also, hypothermia of the body, exacerbation of other chronic diseases can become a trigger mechanism.

The most striking and severe in KSD is renal colic, which develops when there is a violation of the outflow of urine due to an increase in stones or their movement through the urethra, which causes congestive processes, inflammation with a pronounced and acute clinic. An attack of urolithiasis is accompanied by the following disorders:

1. Pain in the lumbar region.
2. Blood in the urine.
3. Disturbed urination.
4. Burning during urination.
5. Increased body temperature.
6. Nausea.
7. Chair disorder.
8. Chills.

With urolithiasis, symptoms may appear suddenly with blockage of the ducts or be increasing. With an attack of renal colic, all symptoms may appear suddenly, without warning. The main symptoms of urolithiasis are manifested in the form of pain, which can be acute, dull, aching or permanent. Any movement leads to increased pain, which often becomes unbearable, gives to the groin and other organs.

In addition to severe pain, there is hematuria (blood in the urine). Stones in urolithiasis can be present in either of the two kidneys, less often there is bilateral damage to the kidney tissues.

When a blockage of the ureter with calculi forms, the pressure in the renal pelvis increases, which leads to its stretching and the appearance of severe pain. Such pathological changes lead to blockage, which can lead to the death of kidney cells.

Renal colic due to obstruction of the ureter

ICD in children and pregnant women

Stone formation in the urinary system can disturb not only adults, but also children, as well as pregnant women. Urolithiasis in children is most often hereditary or develops as a result of a disturbed diet, autoimmune disorders that have caused problems with metabolism. In pregnant women, KSD may occur due to a hormonal imbalance or against the background of an enlarged uterus, which puts pressure on the urinary system. During pregnancy, a woman's kidneys, like the whole body, are forced to work in an enhanced mode, so the risk of developing urolithiasis increases several times.

Pregnancy is not the cause of the formation of stones, but only a trigger for the manifestation of symptoms. The appearance of the disease during pregnancy indicates that the disease was already present in the anamnesis before the onset of pregnancy.

The treatment of nephrolithiasis in pregnant women or children does not differ from other groups of patients, but the choice of therapeutic therapy is always approached individually, taking into account all the characteristics of the organism.

Consequences and complications

With a long-term ICD, the functioning of the kidneys and urinary system is disrupted, so if treatment measures are not taken in time, the consequences can be very complex. Complications of urolithiasis can manifest themselves acutely with the development of renal colic or develop gradually.

1. Cystitis.
2. Paranephritis.
3. Kidney abscess.
4. Sepsis.

With urolithiasis, complications often manifest themselves in the form of the development of chronic renal failure, but this pathology mainly occurs in the presence of stones in the ureter on both sides. To exclude the development of such complications, the treatment process should be started in the early stages, after the results of a comprehensive study.

Acute pyelonephritis is a common complication of urolithiasis.

Diagnostics

In order to exclude complications from urolithiasis, urologists recommend not to hesitate to visit a doctor and seek medical help at the first sign of illness. To recognize the disease, to determine the localization of calculi, their size, to evaluate the work of the organs of the genitourinary system, will help complex differential diagnosis of urolithiasis, which consists of the appointment of laboratory and instrumental methods of examination.

Laboratory diagnostics

1. Blood test - allows you to determine the presence of an inflammatory process, as evidenced by an increased ESR and the number of leukocytes.
2. Urinalysis - determines the pH of urine, the number of leukocytes. Urine tests for urolithiasis are carried out quite often, since they help to identify salt crystals and recognize their composition.
3. Daily urine analysis - allows you to assess the content of various salts in urine.

Instrumental diagnostics

1. X-ray - evaluates the kidneys, ureters and bladder, recognizes stones.
2. Intravenous excretory diagnostics.
3. Ultrasound of the kidneys - visualizes all the structures of the organ, determines the number of stones and other visible disorders in the urinary system.
4. CT or MRI of the kidneys is an informative diagnostic method that allows you to evaluate the work of the entire genitourinary system, to identify the slightest violations in its work.

With urolithiasis, differential diagnosis allows the doctor to draw up a complete clinic, make the correct diagnosis, followed by the appointment of therapeutic therapy.

Principle of treatment

ICD is a group of serious diseases that, if left untreated, can lead to death. Self-medication for this disease is unacceptable, therefore, at the first signs of the disease, you need to seek medical help. Any form of urolithiasis is treated in a complex with the use of:

1. medicines;
2. dieting;
3. herbal medicine;
4. physiotherapy;
5. the right way of life;
6. crushing stones with ultrasound;
7. removal of stones.

With the diagnosis of "urolithiasis" - the diagnosis allows the doctor to decide on the tactics of treatment. First of all, the patient is prescribed therapeutic nutrition, which will directly depend on the biochemical composition of the stones.

If there are stones smaller than 0.5 cm, the doctor may prescribe medication, which will include taking medications from different groups that will help remove stones from the urinary system naturally, relieve inflammation, reduce the risk of their re-formation, and improve kidney function.

Kidney stone disease requires complex treatment, therefore, along with drugs, diet, many turn to traditional medicine. Alternative treatment can only complement therapy, but in no way act as its basis. Benefits will bring decoctions of diuretic herbs, which will include:

1. Birch buds;
2. rose hip;
3. corn silk;
4. lingonberry leaves;
5. nettle;
6. field horsetail;
7. tansy flowers.

To achieve the maximum therapeutic result, doctors recommend combining herbal plants, preparing decoctions, infusions, and taking them in combination with other methods. Phytotherapy can be of great benefit in the treatment of KSD, but it should be used on the recommendation of the attending physician.

If the stones are medium or large, larger then the only way is to crush them with ultrasound or surgery to remove the formations. When treating kidney stones, it is important to follow all the doctor's recommendations, since the risk of recurrence of the disease is always present.

Medical therapy

Urolithiasis - drug treatment includes taking drugs based on herbal ingredients, as well as synthetic drugs to relieve pain in the acute period of the disease. Therapy includes:

1. Herbal preparations - Kanefron, Cyston, Urolesan, Fitolizin.
2. Herbal preparations - allow you to supplement general therapy, improve the functioning of the urinary system. Phytotherapy for urolithiasis ideally complements the main treatment, and can also be used for preventive purposes.
3. Enzymes - dissolve the organic basis of stones, improve the functioning of the gastrointestinal tract: Festal, Mezim, Creon, Pancreatin.
4. Uroseptics - relieve inflammation: Nitroxoline, Palin.
5. Drugs that reduce the production of uric acid - Allomaron, Allopurinol.
6. Antispasmodics - stop the pain syndrome: No-shpa, Spazmalgon, Drotaverine.

Drug treatment includes taking vitamins, minerals, and the doctor may also prescribe other drugs for systemic or symptomatic action. If necessary, antibiotics and drugs from the group of antiplatelet agents are prescribed. For kidney stones, drug treatment may take several weeks or months. It is necessary to take any drug only as prescribed by a doctor, strictly observing the recommended doses. When the acute period is over, the patient is prescribed physiotherapy for urolithiasis, which improves the functioning of the organs of the genitourinary system, reduces the risk of complications and relapses.

In order to avoid relapses, doctors prescribe their patients to take Cyston tablets, a course of 6 months or more. The composition of the drug contains several plants that allow you to remove sand and small stones from the kidneys and ducts of the urinary system.

Operations with ICD

Surgical treatment of urolithiasis is carried out when other methods do not bring the desired result or the stones reach medium or large sizes. Modern urology provides a lot of types of surgical intervention used in KSD. The choice of operation directly depends on the localization of stones, size, and the capabilities of the clinic itself:

Traditional methods of surgery include:

1. Nephrolithotomy.
2. Ureterolithotomy.
3. Pyelolithotomy.
4. Cystolithotomy.

Any operation is performed under general anesthesia. Minimally invasive endoscopic surgeries are popular:

1. Cystoscopy.
2. Ureteroscopy.
3. Ureteropyeloscopy.

These procedures are performed under general anesthesia or spinal anesthesia. The advantage of endoscopic operations is considered to be a short postoperative period, minimal risk of postoperative complications.

After any operation, the patient must periodically visit a urologist for a long time, undergo an ultrasound examination, and take laboratory tests. Controlling the disease will help prevent recurrence of stone formation.

Diet

Diet in ICD is considered one of the most important in the therapy of complex treatment. The doctor should prescribe therapeutic nutrition based on the results of the diagnosis, the type of stones, their location. Nutrition for this disease should be balanced, have a high energy value. In general, you need to exclude from the diet:

1. Salt, spices.
2. Carrots, tomatoes.
3. Chicken and beef meat.
4. Citrus.
5. Sour varieties of apples.
6. Sweets.
7. Young greens.
8. Tea coffee.

The patient's diet should include:

1. Potatoes, pumpkin, peas, prunes.
2. Grapes, bananas, plums, pears.
3. Whole grains.
4. Various cereals.
5. Milk, sour cream, cottage cheese, kefir, hard varieties of syrah.
6. Low-fat fish.
7. Decoctions of herbs with a diuretic effect.

Dieting helps:

• reduce the burden on the kidneys;
• eliminate inflammatory reactions;
• reduce or eliminate the growth of stones;
• prevent re-growth of stones.

It is necessary to adhere to proper nutrition not only during the period of treatment, but also for the prevention of KSD.

Prevention

With the diagnosis of "urolithiasis", prevention should be carried out much earlier than the first signs of the disease appear. People who are at risk or have chronic diseases associated with metabolism should pay special attention to their health. Prevention of urolithiasis consists of observing the following recommendations:

1. Healthy and proper nutrition.
2. Minimal consumption of salt, spices.
3. Active lifestyle.
4. Refusal of fast foods and semi-finished products.
5. Sufficient fluid intake, at least 2 liters per day.
6. Timely and correct treatment of all concomitant diseases.
7. Complete sleep.
8. Frequent interruption in the open air.

An important preventive measure is the timely diagnosis of pathologies affecting the kidneys and genitourinary system. The earlier the disease is diagnosed, the greater the chance of a successful prognosis. Prevention of nephrolithiasis makes it possible not only to reduce the risk of developing the disease, but also to exclude the manifestation of other diseases that affect the abdominal organs.

Pathologies of the kidneys and urinary tract are severe progressive ailments that can provoke complex and sometimes irreversible processes. Ultrasound of the kidneys will help to exclude their development, reduce the risk of complications, which should be done once every 6 months, consult with specialists.

Self-medication should be abandoned, and uncontrolled intake of any medication can even aggravate the situation. Having information about the disease, urolithiasis, its causes, symptoms and treatment methods, you can significantly reduce the risk of development and complications. How to treat urolithiasis can only be prescribed by a doctor after the results of a comprehensive study. With proper treatment, the prognosis is very favorable!

Fast passage:

Urolithiasis - urolithiasis- a disease characterized by the formation of calculi (stones) in the kidneys and / or urinary tract. This is one of the most common urological diseases. It should be noted that residents of Central Asia, the Caucasus, the Volga region, the Far North, Australia, Brazil, Turkey, India, and the eastern regions of the United States suffer more often. This geographical feature of urolithiasis indicates the influence of environmental factors on the occurrence of this pathology.

The reasons:

• hereditary predisposition.
• Congenital predisposition (congenital enzymopathies).
• Violations of colloid-chemical and biochemical processes:
  • According to the theory of catarrh of the pelvis, the organic matter formed as a result of inflammation of the pelvis and desquamation of the epithelium becomes the core of stone formation (matrix).
  • According to the crystalloid theory, supersaturation of urine with crystalloids beyond the solubility limits leads to their precipitation and stone formation.
  • According to the colloidal theory of stone formation, urine is a complex solution supersaturated with dissolved mineral salts (crystalloids) and consisting of finely dispersed protein substances (colloids). The latter, being in a chemical relationship with crystalloids, keep them in the urine of a healthy person in a dissolved form, i.e., a colloid-crystalloid equilibrium is created. In violation of the quantitative and qualitative ratios between colloids and crystalloids in the urine, pathological crystallization and stone formation can occur.
  • One of the significant factors of stone formation is the reaction of urine (pH). It determines the optimum activity of proteolytic enzymes and the sedimentation of urinary salts.)
• Violation of urodynamics (violation of the outflow of urine). Difficulty in the outflow of urine from leads to impaired excretion and resorption of the constituent elements of urine, precipitation (crystallization) of salt sediment, and also creates conditions for the development of the inflammatory process. Conditions in which the outflow of urine is often disturbed:
  • primary and secondary stenosis (narrowing) of the ureteropelvic segment,
  • urinary tract anomalies
  • (kidney prolapse)
  • (reverse flow of urine from to),
• Endogenous factors:
  • hypercalciuria (increased levels of calcium in the urine),
  • A-avitaminosis,
  • D-avitaminosis or an overdose of vitamin D,
  • hyperparathyroidism,
  • bacterial intoxication with common infections and,
  • the use of large amounts of certain chemicals (sulfonamides, tetracyclines, antacids, acetylsalicylic acid, glucocorticoids, etc.),
  • prolonged or complete immobilization, etc.

Types of urinary stones:

• Urates - stones consisting of salts of uric acid, yellow-brown, sometimes brick in color with a smooth or slightly rough surface, quite dense. Formed when urine is acidic.
• Phosphates - calculi, consisting of salts of phosphoric acid, grayish or white, fragile, easily broken, often combined with infection. Formed in alkaline urine.
• Oxalates - consist of calcium salts of oxalic acid, usually dark in color, almost black with a spiky surface, very dense. Formed in alkaline urine.
• Rarely there are cystine, xanthine, cholesterol calculi.
• Mixed stones are the most common type of stones.

Symptoms of urolithiasis

The main clinical manifestations of KSD are associated with impaired urodynamics (impaired urine outflow) and/or an inflammatory process. In the early stages, the disease may be asymptomatic. Moreover, the size of the calculus is not always comparable with the severity of complaints: the largest calculi (coral stone) may not bother a person for a long time, while a relatively small calculus in the ureter leads to renal colic with severe pain manifestations. Thus, the clinical manifestations depend primarily on the localization of the stone and the presence or absence of an inflammatory process.

Here are the main symptoms of urolithiasis:

• may be acute (renal colic) or dull, aching in nature. The cause of renal colic is a sudden violation of the outflow of urine from the kidney, as a result of obstruction of the ureter by a stone. The pain is sudden, with periods of relief and repeated attacks. The pain is localized in the region of the kidney or along the ureter and has a typical irradiation down to the iliac, inguinal region. Patients behave uneasily, not finding the position of the body in which pain would decrease. Dull, aching nature of pain is characteristic of the inflammatory process against the background of ICD.
• Hematuria (blood in the urine) with urolithiasis occurs as a result of a sharp increase in intrapelvic pressure (with renal colic) with the formation of pyelovenous reflux (reflux of urine into the venous bed), which is manifested by total macrohematuria after the relief of renal colic. Also, when a calculus passes through the ureter, it is possible to injure the latter.
• Dysuria (impaired urination), in the form, is usually formed when a calculus is located in the lower third of the ureter, or when a large calculus is present in the bladder. For this reason, erroneous overdiagnosis of and is possible. or interruption of urination may occur with stones in the bladder and urethra.
• : an increase in the number of leukocytes in the urine - indicates the addition of a urinary tract infection.
• : lack of urine due to a violation of the outflow of urine - possible in the presence of stones in both ureters or with a stone in the ureter of a single kidney. Postrenal anuria requires urgent therapeutic measures.

Diagnostics

• . Usually, with urolithiasis, changes in the parameters of the general blood test are not observed. However, if renal colic occurs or pyelonephritis is formed, it may be noted,.
• :
  • Minor, microhematuria (the presence of red blood cells in the urine) may be observed.
  • In the presence of calculous pyelonephritis, leukocyturia and usually join. However, with renal colic, urine values ​​\u200b\u200bmay be normal, since the calculus can completely block the passage of urine from this kidney.
  • . can be detected episodic and often depend on the nature of nutrition and. Uric acid crystals with urine pH less than 6.0 are characteristic of urate nephrolithiasis and uric acid diathesis; phosphate crystals of calcium and magnesium at a urine pH of 7.0 and above - for phosphate urolithiasis and phosphaturia; calcium oxalates - for calcium oxalate urolithiasis or oxaluric diathesis.
• and urine includes the determination of the content, calcium, magnesium, inorganic phosphorus, etc.:
  • Hyperuricemia (increased levels of uric acid in the blood) and hyperuricuria (increased levels of uric acid in the urine) indicate impaired synthesis of uric acid, which occurs with uric acid diathesis, gout, and can lead to the formation of urate stones.
  • Hyperphosphaturia (increased levels of phosphorus in the urine) may be a manifestation of phosphate diathesis, congenital or acquired due to primary diseases of the stomach or central nervous system. More often, phosphaturia is false (pH 7.0 and higher), which depends on alkali-forming bacteria (Proteus).
• The study of the level of hormones (calcitonin and parathyroid hormone) is carried out in the diagnosis of hyperparathyroidism, especially in patients with staghorn, bilateral and recurrent stones with elevated serum calcium levels. An increase in the level of calcium (hypercalcemia), a decrease in the level of phosphorus and magnesium in the blood serum are signs of impaired metabolism, which are considered as risk factors for recurrent stone formation and require the exclusion of the renal form of primary hyperparathyroidism.
• Bacteriological examination (sowing) of urine allows you to identify the microflora of urine and determine the titer (number) of bacteria. Bacteriological cultures of urine with the determination of the sensitivity of microflora to antibacterial drugs allow for the etiotropic treatment of pyelonephritis, which is one of the causes of recurrence of stone formation.

Radiation methods for diagnosing urolithiasis:

• Ultrasound diagnosis allows visualization of stones located in the kidneys, bladder, upper and lower thirds of the ureter. In this case, it is possible to determine the size of the calculus, its shape, location. Violation of the outflow of urine from the kidney caused by a calculus (stone) of the ureter on ultrasound is manifested by the expansion of the pyelocaliceal system.
• X-ray methods of research. Calculi (stones), from the point of view of X-ray examination, can be X-ray negative (not visible with a standard X-ray) and X-ray positive (visualized with a standard X-ray). X-ray negative calculi are calculi consisting of uric acid salts (urates). The remaining calculi, including mixed ones, are X-ray positive. In order to visualize X-ray negative stones, excretory radiography (X-ray examination using a radiopaque substance administered intravenously) is used. There are also additional X-ray studies, which we will not dwell on.

Treatment of urolithiasis:

• Symptomatic treatment:
  • antispasmodic therapy;
  • anti-inflammatory agents.
• Litholytic therapy (dissolution of stones) - is based on the shift of the pH-urine in the direction opposite to that in which the concrete form of stones is formed.
• Temporary restoration of urine outflow:
  • installation of a ureteral catheter;
  • nephrostomy.
• Remote crushing of calculi (DLT).
• Operative excision of the calculus.

Prevention of urolithiasis

• Normalization of metabolic disorders.
• Increase the amount of fluid consumed (in the absence of contraindications).
• Urine pH adjustment.
• Diet correction.
• Correction of hormonal disorders.
• Vitamin prophylaxis and mineral prophylaxis of urolithiasis.

Among diseases of the urological orientation, urolithiasis occupies the second position in terms of frequency of occurrence after infectious inflammatory processes. There is a trend towards a steady increase in its prevalence, in some regions there is a situation that is taking on an epidemic character.

Urolithiasis can develop at different ages, but is more common between 20 and 55 years of age. Men are more prone to kidney stones, they have symptoms of urolithiasis several times more often than women. In the latter, complex forms of this disease are more common with the formation of stones inside the kidney.

Stones can appear in any organ of the excretory system. Elderly patients are characterized by the formation of deposits inside the bladder; in younger patients, the formation of insoluble structures often occurs in the ureters and kidneys. In the kidney on the right, neoplasms form more often than on the left..

Calculi can be single, but sometimes their number reaches several thousand. Their size is different - from 1-5 mm to huge, reaching a weight of 1 kg.

The mechanism of development of urolithiasis is not fully understood. There is also no single picture that could unite all the numerous theories of stone formation. Usually, the symptoms and treatment of urolithiasis are difficult to classify into one scheme, and in each individual case, the doctor decides on the appointment of certain drugs.

CAUSES

Urolithiasis is a polyetiological chronic condition. Considering its causes, it is customary to designate the main and secondary circumstances.

The main influence is exerted by external and internal factors, which by their action are capable of changing metabolic processes and blood composition.

Main reasons:

• genetic propensity;
• chronic diseases of the digestive system (ulcer, colitis,) and the genitourinary system (prostate adenoma,);
• violations in the work of the parathyroid glands that regulate calcium metabolism;
• deficiency of important vitamins A, D and group B;
• long-term use of drugs (ascorbic acid, tetracyclines, aspirin, sulfonamides, glucocorticosteroids);
• chronic diseases of bone tissue associated with calcium loss;
• features of the climatic zone of residence (hot climate contributes to dehydration of the body and an increase in the concentration of salts in the urine);
• regular drinking of water with a high degree of hardness, with a high content of calcium salts;
• prolonged dehydration of the body in various infectious diseases and poisonings;
• local changes in the urinary tract;
• sedentary lifestyle, immobilization after injury.

The main predisposing factor is hereditary, but in the absence of other negative influences, the disease cannot develop. A significant role in the development of the pathological process is played by the calorie content of food, the increased content of animal protein in the diet, the abuse of salty foods, foods rich in calcium, oxalic or ascorbic acid.

In large cities, where water of increased hardness is supplied through centralized water supply networks, all residents are at risk.

CLASSIFICATION

About 70% of cases of the disease occur with the formation of stones of calcium origin, the rarest are protein ones.

Classification by location of stones:

• ureterolithiasis - ureters;
• nephrolithiasis - kidneys;
• cystolithiasis - in the bladder.
• Classification by the number of stones:
• single;
• multiple;
• coral.
• Classification according to the composition of the formed stones:
• polymineral;
• based on uric acid (urates);
• from calcium salts (carbonates, oxalates, phosphates);
• magnesium derivatives;
• protein origin (xanthine, cholesterol, cystine).

SYMPTOMS

The clinical picture of the disease depends on the number of stones, their size and localization.

Periods of development of urolithiasis:

• Asymptomatic - there are no manifestations of the disease, it is possible to determine the presence of stones in the urinary system using additional methods.
• The acute stage is manifested by such symptoms of urolithiasis as pain, urinary retention.

Usually pain is localized in the lower back. They are felt constantly or occur periodically, have a dull or acute character. The severity of the pain syndrome and its irradiation will directly depend on the location and size of the stones. When moving, working hard, or while riding in a vehicle, the pain may become more intense. During the migration of crushed residues, bouts of renal colic which are shown by the strongest attacks after blockade of an ureter by a stone. In this area, pressure rises significantly, which provokes severe symptoms of colic. This condition may be accompanied by abdominal muscle tone, nausea and vomiting.

The passage of stones along with urine is considered a clear sign of urolithiasis. Their ability to leave the body depends on the size, location and tone of the muscles of the excretory tract. The admixture of stones can be microscopic or visible to the naked eye.

The defining symptom is also, or the appearance of traces of blood in the urine. This sign of urolithiasis is observed in the vast majority of patients (about 92%) during the passage of stones. These symptoms are often accompanied nausea, vomiting, subfebrile body temperature and false urge to urinate.

DIAGNOSTICS

The signs of urolithiasis are similar in their manifestations to the symptoms of other pathologies of the organs of the retroperitoneal region and the abdominal cavity, therefore, differential diagnosis is carried out to exclude the condition of an acute abdomen (ectopic pregnancy, colitis, acute, sciatica, ulcer,).

Diagnostic steps:

• Examination and history taking. To identify the etiology and pathogenesis of the disease, the urologist needs information about the type of human activity, his eating style, the features of the development and course of the disease, the use of medicines, as well as past operations, injuries, and prolonged immobilization.
• Visualized study of the stone. To visualize an insoluble formation, the method of ultrasound examination of the excretory tract is used. This method allows you to identify both radio-positive and radio-negative calculi. Also, spiral computed tomography, survey and excretory urography are used to obtain information about the location, shape, composition of the stone and the state of the urinary system.
• Clinical researches include biochemistry, a general blood and urine test to identify the inflammatory process and the severity of renal failure. To determine the sensitivity to antibiotics, microflora is cultured.
• Kidney examination radioisotropic and biochemical methods.
• Pneumopyelography, retrograde urethropyelography, urethropyeloscopy.
• The study of tomographic density of formations to prevent possible complications.
• Analysis of the received calculus.

TREATMENT

When determining the tactics of treating urolithiasis, the urologist pays attention to the patient's age, general health, location, size and composition of the stone. Therapy includes methods of conservative and surgical treatment.

Treatment Method consists in the destruction of stones, their elimination, as well as in the normalization of metabolic processes that affect the formation of formations. It has been established that only stones up to 5 mm in diameter can spontaneously leave the body, a successful outcome is much less common if the stone size is 5-8 mm.

The main types of treatment:

Conservative treatment is possible if urates are detected. At the same time, citrate mixtures are prescribed for 2-3 months, under the influence of which the stone gradually dissolves. Drugs that suppress the production of uric acid and promote its rapid excretion from the body are also used. The appointment of enzymes helps to dissolve the organic basis of the stone.

Medical treatment of calcium stones limited to vitamin therapy and drugs that promote accelerated excretion of calcium. Taking into account bacteriological culture, antibiotics can be prescribed, but the effectiveness of drug treatment in this case is low.

Stones of any other origin are removed promptly.

Purification of kidney and bladder stones does not exclude the recurrence of urolithiasis in the future, so prevention methods should be aimed at suppressing pathological processes in the body.

In the past, the only way to get rid of urinary tract stones was through open surgery. Now indications for it are large stones, the development of renal failure, their localization in the kidney of a calculus with complications in the form of purulent pyelonephritis.

Types of surgical treatment:

Remote non-contact lithotripsy is used as a modern method of surgical intervention. The reflector of the apparatus emits electro-hydraulic waves, under the influence of which the stone is crushed. Then small particles and sand pass spontaneously with urine, sometimes this process is accompanied by mild colic. Several lithotripsy procedures may be required to completely crush the formations.

Minimally invasive surgical treatments also include percutaneous nephrostomy. Under the control of an x-ray machine, they penetrate into the urinary tract through a puncture, where urine is drained and stones are crushed. in this case does not develop, which facilitates the postoperative period.

At any stage, analgesics are used as symptomatic therapy to alleviate the patient's condition. In inflammatory processes and in the postoperative period shown a course of antibiotics. A special place during the treatment period and for the rest of life is given to the diet.

COMPLICATIONS

Common complications of urolithiasis:

• Chronic inflammation in the area of ​​​​the calculus, expressed by pyelonephritis, or cystitis, which, against the background of negative influences (viral diseases, hypothermia), turn into an acute form.
• Chronic pyelonephritis, which rapidly progresses to renal failure.
• Acute inflammation of the kidneys can be aggravated by paranephritis with the appearance of pustular lesions of the tissues of the organ. In the future, an abscess and blood poisoning are likely, which is a direct indication for surgical intervention.
• Ischuria, or acute retention of urine.
• Pyonephrosis is a severe complication of purulent pyelonephritis, characterized by destruction and melting of the kidney tissue.
• Anemia occurs as a result of constant blood loss from hematuria.

The most dangerous is the bilateral form of the disease. In this state of affairs, a symptom of urolithiasis will be severe pain from both sides, as well as all other characteristic signs.

Diet in the treatment of urolithiasis

In order to increase the effectiveness of the main therapy, successfully practiced in integral medicine (combination of herbal remedies and medical procedures), a special diet is prescribed. In each individual case, the doctor draws up a certain regimen, and takes into account the peculiarities of nutrition. After analyzing the state of the body and determining the nature of the stones, an appropriate menu is recommended.

When stones such as uric acid stones are found, the diet is always based on the rejection of offal, strong meat broths, and also involves reduction in the consumption of any fats of vegetable origin and meat.

In the case of diagnosing phosphate stones in a patient in the kidneys, the diet is based on the exclusion or significant reduction in the diet of dairy products, increasing the consumption of meat dishes. Usually, whatever the symptoms and treatment of urolithiasis, during the diet you need to drink plenty of water - about two liters per day, and the liquid that is already in the products is not taken into account.

PREVENTION

The task of prevention is to correct violations of metabolic processes.

The main preventive measures:

• sufficient physical activity;
• weight loss to optimal levels;
• limiting the consumption of alcoholic beverages;
• prevention of stressful situations;
• expansion of the drinking regime to 2.5-3 liters during the day;
• restriction of the use of proteins of animal origin, their replacement with vegetable ones;
• an increase in the intake of calcium and citrates with a tendency to urate, calcium and oxalate lithiasis.

Depending on the composition of stones that have been observed in the past, preventive measures will be adjusted towards a change in diet.

If the rules for preventing the development of urolithiasis are not observed within five years after getting rid of stones, they re-form.

PROGNOSIS FOR RECOVERY

Modern methods of medical and surgical therapy allow successfully treat urolithiasis give an opportunity to talk about a favorable prognosis. But factors such as urinary tract infections, as well as the composition of the stone and the state of acidity of the urine, can aggravate the course of the disease and contribute to the development of complications.

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Medium-sized stones are more likely to form in the kidneys. When they are fixed at the site of formation, there may not be any symptoms. However, when the stone moves along the ureter in places of greatest narrowing, the stone clogs the ureter - symptoms of renal colic appear.

Symptoms of renal colic

• paroxysmal pain - periodically aggravated
• Possible increase in body temperature

• Salts in the urine
• erythrocytes in urine
• cloudy urine

Symptoms of stones of various localization

Symptoms of stones in the calyx

More often, calyx stones are small and are excreted in the urine. With abundant urination (with heavy drinking, drinking alcohol, taking diuretics). Perhaps exacerbation of pain due to the active promotion of stones.
The nature of the pain:

• Pain is paroxysmal
• Localized pain in the lumbar region in the lower abdomen or in the groin.
• The pain is exacerbated by shaking, active movements.

Symptoms of stones in the renal pelvis

medium sized stones most often cause a serious condition - blockage of the ureter and an attack of renal colic.
Symptoms of renal colic:
General symptoms:

• paroxysmal pain - periodically aggravated,
• Pain occurs suddenly, often with movement, shaking, heavy fluid intake or alcohol. Changing position does not relieve pain.
• Possible increase in body temperature
• Pain can be given to the lumbar region, to the lower abdomen, to the inguinal region (depending on the level of ureteral obstruction).

Stones in the ureters

Localization of the stone in the upper third of the ureter

• Pain in the lumbar region
• The pain is acute, periodically subsides (but not completely), with periods of intensification
• Change in body position does not affect the intensity of pain
• Pain may radiate to the side of the abdomen

• The pain is localized in the lateral projection of the abdomen - along the lower costal edge
• Gives to the iliac and inguinal region
• Changing the position of the body does not affect the intensity of pain.

• Localization of pain - lower abdomen, groin area
• Pain radiates to the scrotum/external labia
• Feeling of a full bladder
• Frequent urge to urinate
• Urination itself is painful, does not lead to a feeling of emptying the bladder

Stones in the bladder

• Periodic pain in the lower abdomen
• Pain can be given to the perineum, external genitalia
• Pain gets worse or comes on with movement
• When urinating, the stream of urine may suddenly break off, with a change in body position, urine discharge may resume.

Reasons for the formation of stones

• Climate (dry, leading to frequent dehydration)
• Soil structure - affects the electrolyte composition of food
• The chemical composition of water - the excess presence of salts in the water can contribute to an increase in their concentration in the urine. The acidity of the water is also of great importance for stone formation in the urinary organs.
• Mode and amount of fluid intake - insufficient fluid intake increases the risk of stone formation.
• Daily routine - a sedentary lifestyle contributes to the formation of stones
• The composition of daily food intake is excessive consumption of meat products, products with a high content of purine bases (peas, sorrel, spinach, etc.).

• Urinary tract infections: cystitis, urethritis, prostatitis, pyelonephritis
• Infectious diseases of other organs (tonsillitis, furunculosis, osteomyelitis)
• Diseases of the digestive tract: colitis, pancreatitis, cholelithiasis, hepatitis
• Anomalies in the development of the kidneys, ureters, bladder.

Diagnosis of urolithiasis

The diagnosis of urolithiasis is made on the basis of the following data:

Symptoms of the disease

1. intermittent sharp pains (like colic) in the lumbar region, lower abdomen or groin)
2. incomplete emptying of the bladder
3. burning sensation in the urethra when urinating

Data of examination and physical examination of the patient

1. palpation of the abdomen - allows you to exclude many acute inflammatory diseases of the abdominal organs (pancreatitis, adnexitis, appendicitis, cholecystitis). These diseases, by their external signs and symptoms, can be similar to an attack of renal colic.
2. tapping the abdomen and lumbar region - allows you to exclude or identify signs of diseases such as: sciatica, lumbago, pyelonephritis.
3. external examination of the patient - the forced posture of the patient (in which he feels a decrease in soreness), the presence of edema, skin color may indicate many diseases of the urinary system.

CT diagnostic data this examination allows you to accurately diagnose urolithiasis and identify the shape, size and localization of stones.

X-ray diagnostic data - this method is used for a more detailed study of the flow of urine through the urinary tract, allows you to identify at what level there is a blockage of the urinary tract.

Data from a general urinalysis study- The following data may indicate the presence of urolithiasis:

1. Increased density of urine
2. The presence of unchanged red blood cells
3. The presence of a high concentration of salts
4. Detection of sand in the urine

Treatment of kidney stones with medicines

** The appointment of medicines, determining the dosage and time of admission is carried out only by the attending physician.

Dissolution of stones with medicines

Treatment of urinary stones folk remedies

Physiotherapy for urolithiasis

Treatment of urolithiasis in a sanatorium

Methods for crushing stones in the kidneys and ureters(lithotripsy)

Operations for urolithiasis

Indications for surgery for urolithiasis:

• large stones when they cannot be crushed and removed without surgery;
• significant impairment of kidney function, despite the fact that other methods of treatment in this case are contraindicated;
• the position of the stone: if it is inside the kidney, then it is very difficult to crush it and bring it out;
• complication in the form of a purulent process in the kidneys (purulent pyelonephritis).

Pyelolithotomy. Removal of a urinary stone from the renal pelvis through an incision. Often, such an intervention is resorted to in the presence of large stones, coral-like stones.

Nephrolithotomy. A complex surgical intervention, which is performed with especially large sizes of stones that cannot be removed through the renal pelvis. In such situations, the incision is made directly through the tissue of the kidney.

Ureterolithotomy. An operation that is currently performed very rarely. This is the removal of a ureteral stone through an incision in the wall of the ureter. In most cases, the removal of such stones can be performed using endoscopic techniques, without an incision.

Help with renal colic

If the pain bothers you on the left, then you can apply a hot heating pad to the kidney area, take antispasmodics (No-shpa, Drotaverine, Papaverine).

First aid is provided by the ambulance team on the spot and in the emergency department of the hospital where the patient is taken. A combination of drugs is administered.

Composition of the mixture:

• analgin (or baralgin) - pain reliever;
• papaverine - antispasmodic (eliminates spasm of the ureters);
• dibazol - antispasmodic, lowers blood pressure.

• after the drugs are administered, acute pain does not go away;
• fever, vomiting;
• lack of urine as a result of blockage of the lumen of the ureter by a stone;
• an attack of renal colic is bilateral;
• The patient has only one kidney.

Diet for urolithiasis

How are kidney stones formed?

• genetic predisposition;
• Bad ecology;
• Features of nutrition;
• Region of residence - in some areas the water is hard and contains a lot of salts;
• Hormonal imbalance, especially disorders of the parathyroid gland;
• Metabolic disorders, in particular mineral metabolism;
• Anatomical features of the structure of the kidneys and urinary tract (weakness of the ligaments that support the kidney);
• Deficiency of substances that slow down crystallization (citrate, pyrophosphate, nephrocalcin, uropontin);
• Inflammation in the renal pelvis;
• Reception of sulfonamides and tetracyclines, nitrofuran together with ascorbic and other acids.

The process of stone formation begins with the fact that the concentration of salts in the urine increases, and they become insoluble. Salts crystallize around a colloidal "core" - a large organic molecule that is the basis of a kidney stone. Subsequently, new crystals form and grow on this matrix.

Recent studies have found that almost all stones (97%) contain nanobacteria so named because of their small size. These atypical Gram-negative (not Gram-staining) organisms produce apatite (calcium carbonate) during their vital activity. This mineral is deposited on the walls of the kidney cells, promoting the growth of crystals. Nanobacteria infect the epithelium of the collecting ducts and the zone of the papillae of the kidneys, creating foci of calcium phosphate crystallization around them, and thereby contribute to the growth of the stone.

What stones are formed in the kidneys with urolithiasis?

In 30% of women who suffered from urolithiasis before pregnancy, exacerbations occur, especially in the third trimester. This is due to a change in the drinking regimen and thickening of the mucous walls of the ureters. In addition, hormonal and anatomical changes in the body of a pregnant woman contribute to the development of inflammation around the stone, which leads to pyelonephritis.

Causes of the appearance and exacerbation of KSD in pregnant women.

• Violation of salt metabolism. During the period of bearing a child, phosphorus-calcium metabolism and reabsorption (reverse absorption from primary urine) of uric and oxalic acids are disturbed. Therefore, phosphate, urate and oxalate stones are predominantly formed.
• Decreased tone and expansion of the renal calyces and pelvis . Their volume increases by 2 times compared with the period before pregnancy. A decrease in tone leads to the fact that the sand is not removed from the kidney, but is overgrown with new crystals.
• Frequent urinary infections in pregnant women in which mucus, pus and epithelial cells take part in the formation of the core of the stone. The infection rises from the bladder with vesicoureteral reflux (reverse reflux of urine), penetrates the lymphogenous route with constipation or hematogenous with inflammatory bacterial diseases.
• The effect of the hormone progesterone on urinary tract receptors. Under its influence, the processes of formation and excretion of urine slow down. A decrease in the tone of the ureter from the 3rd to the 8th month causes stagnation of urine in the pelvis.
• Pathological mobility of the kidney can cause torsion of the ureter and obstruct the flow of urine. It develops due to the fact that the ligaments in pregnant women become more elastic and weakened.
• Uterine pressure. In the second half of pregnancy, the uterus deviates to the right and compresses the ureter, worsening the dynamics of urine. In this regard, in pregnant women, a predominantly right-sided lesion occurs.

Pain occurs in the upper part of the lower back, can be given to the stomach, genitals, leg. The woman is trying to take a forced position to alleviate the condition: on a healthy side, knee-elbow.

As the stone progresses, the condition may improve, but dull pain in the lower back remains. It should be noted that attacks of renal colic in pregnant women are more easily tolerated than in other patients. Perhaps this is due to the increased elasticity of tissues during the period of bearing a child.

Small stones depart almost asymptomatically and they are indicated only by traces of blood found in a general urine test. The passage of stones occurs mainly before 34 weeks, then the enlarged uterus compresses the ureters and the risk of renal colic increases.

If severe pain occurs, you should immediately call an ambulance or take the pregnant woman to the emergency room of the hospital. Although the attack of colic itself does not pose a threat to the life of the mother or fetus, pain and arousal can cause spontaneous abortion or premature birth, especially in the later stages.

Diagnostics

How to prevent urolithiasis?

Particular attention to prevention should be paid to people whose relatives suffer from urolithiasis. Since there is a high probability that the tendency to form stones is inherited.

Can kidney stones dissolve?

Drugs can dissolve:

• Urate stones;
• cystine stones;
• struvite stones;
• Phosphate stones.

• Small diameter - stones less than 4 mm dissolve well. A stone larger than 2 cm should preferably be crushed into smaller fragments by remote or contact endoscopic crushing.
• Sour urine reaction. Acid stones are looser and more susceptible to lysis.

Dissolution of urate stones. For dissolution are used:

Dissolution of cystine stones

• Thiopronin is a complexing agent that binds cystine. Provides dissolution of cystine stones. When taking it (800-1000 mg per day), it is necessary to consume a sufficient amount of liquid - 2.5-3 liters. The dose is divided into 2-3 parts, taken after meals.
• Penicillamine has a similar effect but has more side effects than thiopronin. Take 500 mg 4 times a day, one hour before meals. The last evening dose should be increased. Before going to bed, you need to take an additional 0.5 liters of water.
• Captopril binds cysteine ​​in the urine and removes it from the kidneys, preventing it from being converted to cystine. Gradually dissolves stones. Assign 20-50 mg 3 times a day, on an empty stomach.
• Drinking plenty of water normalizes the acidity of urine and reduces the concentration of salts.

• Lithostat (acetohydroxamic acid). Blocks urease, an enzyme produced by bacteria that is a component of struvite stones. Softens stones and causes them to be crushed and excreted in the urine. Take 250 mg 3-4 times a day.

• Methionine 500 mg 3-6 times a day increases the acidity of the urine.
• Ammonium chloride 70-300 mg 3 times a day orally after meals prevents precipitation in alkaline urine.
• Acetohydroxamic acid - 250 mg 3-4 times a day, after meals. Assign for the oxidation of urine with the ineffectiveness of methionine and ammonium chloride.
• Cranberry extract 2 tablets 3 times a day increases the acidity of the urine and promotes the dissolution of phosphates.

To dissolve stones, it is extremely important to follow a diet and avoid foods that increase stone formation.

The kidneys around the clock cleanse our body of various harmful and unnecessary products. Every 7-8 minutes the blood of each person completely passes and is filtered through them. Unfortunately, in the work of the kidneys, however, like any other organs, serious disturbances can occur due to the formation of stones in the urinary tract. This disease is called urolithiasis. What causes and develops this disease? In this article, we will talk with the editors of the site www.site about the causes of urolithiasis and its development.

The formation of stones occurs not only in diseases of the internal organs, but also from some environmental factors.

Gradual deposits of salts around any particle, for example, a microorganism, lead to the appearance of stones in the ureters and kidneys. Being for a long time in one place and blocking, thereby, the outflow of urine, the stones make changes in the urinary tract. This may be a local expansion of the ureter or kidney, as well as a malnutrition of their tissues, which usually leads to a gradual loss of organ function.

Causes of the appearance and development of urolithiasis

There are external and internal factors that contribute to the emergence and further development of the ICD.

The main internal factor can be attributed to the violation of metabolic processes in the human body - fat, mineral or protein metabolism, as a result of which excess substances are formed that precipitate. Metabolic processes can be both a consequence of diseases and an independent state.

Violation of the outflow of urine from the kidneys through the ureters to the bladder and further from it to the urethra is an important factor in the development of KSD. With such a violation, urine can be thrown back against the current or stagnation in the bladder or kidneys, which leads to the accumulation of salt deposits.

The outflow of urine can be disturbed as a result of congenital malformations of the urinary organs, various inflammatory diseases, as well as traumatic injuries. For example, narrowing of the ureter, nephritis, kidney prolapse, cystitis, etc.

Various diseases of the gastrointestinal tract, musculoskeletal system, liver and other organs can also cause the development of urolithiasis.

Abnormalities in the work of the adrenal glands and the thyroid gland are internal factors that contribute to the formation of stones in the urinary tract.

External factors affecting the development of urolithiasis:

Excessive content of table salt in food;

Lack of fluid;

Abuse of various spices containing salt;

The use of a large number of smoked foods and alcoholic beverages;

Self-administration for a long time of drugs such as aspirin, antibiotics, hormonal agents, agents that help reduce the acidity of the gastrointestinal juice;

Chronic pyelonephritis.

The latter cause contributes to the formation of salt deposits in the kidneys and urinary tract in 30-35% of cases. Moreover, urolithiasis caused by chronic pyelonephritis is very difficult and can reappear even after treatment and removal of stones.

The composition of the stones can vary and be phosphate, urate, carbonate and oxalate. In the renal pelvis, several stones can form at the same time. During the interictal period, urolithiasis can occur without any special symptoms, the patient usually has no complaints.

But over time, with the development of renal colic, ICD attacks begin to appear. Renal colic can be provoked by heavy physical exertion, alcohol abuse, and the intake of large amounts of liquid. It can manifest itself as a sharp, paroxysmal pain in the lumbar region. Such a painful attack is associated with the movement of the stone through the ureters. After the passage of the stone, the attack stops. In addition to pain, high blood pressure, body temperature are often observed, nausea, vomiting appear, and the amount of urine excreted decreases.

Currently, urolithiasis is diagnosed using an ultrasound examination of the kidneys, radiography, and a general urine test.

As first aid, you can use a hot heating pad, which must be applied to the lumbar region, and if there are no contraindications, you can take a hot bath. In addition, experts recommend painkillers in tablets and antispasmodics (for example, no-shpa). If there is no effect from these methods, then it is urgent to call an ambulance.