There are bladder stones. Stones in the kidneys and bladder, treatment with folk remedies, symptoms, causes, signs. Signs of stones in the bladder

N21.0 Bladder stones

Epidemiology

According to clinical statistics, among patients with bladder stones, 95% are men over 45-50 years old, suffering from urinary stasis due to obstruction of the bladder outlet in benign prostatic hypertrophy.

A family history of pathology can be traced in 25-30% of cases of detection of bladder stones in men.

The World Journal of Urology experts note that dietary changes over the past decades have affected the frequency and chemical composition of stones, with calcium oxalate stones being the most common now.

In countries with hot climates - compared with temperate climates - an increase in the number of patients with urolithiasis and more frequent formation of bladder stones (especially urate and oxalate) have been recorded. This is explained by the lack of fluid in the body at high air temperatures and the specifics of the diet.

Bladder stones are also common in developing countries in children and adolescents due to urinary tract infections and lack of protein. Experts from the American Urological Association note that approximately 22% of stones in pediatric patients

found in the bladder, and the most common are oxalate, phosphate, and struvite stones.

In Western Europe, the USA and Canada, the appearance of stones in the bladder was recorded in 7-12% of cases of visits to urologists; the main causes of cystolithiasis are prostate problems and metabolic disorders (including diabetes and obesity).

According to the European Association of Urology, up to 98% of small stones (less than 5 mm in diameter) are spontaneously passed in the urine within four weeks of symptom onset. But larger calculi (up to 10 mm in diameter) come out of the bladder on their own in only half of the cases.

Causes of bladder stones

The reasons for the formation of stones in the bladder are an increase in the concentration of urine and the crystallization of the salts contained in it. Urine that accumulates in the bladder is periodically removed - during urination (miction), but some of it can remain in the bladder, and in urology it is called residual urine.

The pathogenesis of cystolithiasis is due to incomplete emptying of the bladder (infravesical obstruction), increased pressure in it and stagnation of residual urine. It is under such conditions that the specific content of salts increases many times, and in the first stage they turn into small crystals. This is the so-called "sand", which is partially excreted in the urine (because it passes relatively easily through the ureter). However, a certain amount of tiny crystals settles on the wall of the bladder, and over time their number and size increase, which causes the formation of crystalline conglomerates of various compositions. This process is accelerated by insufficient fluid intake and deviations from the physiologically normal acid-base properties of urine.

But the reasons for incomplete emptying of the bladder with the constant presence of residual urine in it in clinical urology are:

• chronic urological infections (in particular, recurrent cystitis creates conditions under which dystrophy of the muscular wall of the bladder develops, the volume of residual urine increases and bladder stones begin to form in women);
• prostate enlargement (benign prostatic hyperplasia or adenoma), most often causing bladder stones in men;
• prolapse of the bladder (cystocele), provoking the onset of cystolithiasis in older women, as well as bladder stones during pregnancy, especially multiple. In men, the bladder descends when overweight or lifting weights;
• dysectasia (fibroelastosis) of the bladder neck;
• strictures of the urethra (narrowing of the lumen of the urethra) of various etiologies;
• the presence of a diverticulum in the bladder;
• bladder innervation disorders resulting from brain or spinal cord injuries, cauda equina syndrome, diabetes, heavy metal poisoning, etc., which lead to neurogenic detrusor hyperactivity (or reflex spinal bladder).

Problems with emptying the bladder are accompanied by prolonged bed rest, bladder catheterization, radiation therapy for tumors of the pelvic organs and lower intestines.

Finally, at the same time, stones in the kidneys and bladder appear in the presence of urolithiasis, when a small stone formed in the renal pelvis moves along the ureter into the cavity of the bladder.

Risk factors

Numerous studies indicate that the main risk factors for the development of both cystolithiasis and urolithiasis are the characteristics of metabolism in the body and the nature of human nutrition.

When the glomerular filtration of the kidneys is impaired, and there are also problems with the metabolism of purines and pyrimidines (which happens with increased consumption of meat), the body cannot cope with the utilization of nitrogenous bases and uric acid: the content of uric acid salts increases in urine and uraturia with uric acid stones is noted. More information in the article - Urates in the urine

And with phosphaturia, which is observed if dairy products predominate in the diet, there is a high level of phosphate salts of calcium, magnesium or ammonium (phosphates) in the urine.

By the way, these metabolic disorders - due to a congenital deficiency of certain hormones and enzyme substances - in a significant proportion of cases are a genetically determined predisposition, which in urology is defined as saline diathesis or uric acid diathesis.

Symptoms of bladder stones

Sometimes bladder stones cause no symptoms and are discovered by chance during X-rays.

And the first signs of the presence of stones can be manifested by a change in the color of urine (from almost colorless to abnormally dark) and discomfort when urinating.

With larger sizes of calculi - due to irritation of the mucous membrane of the bladder and urethra - there are such symptoms of stones in the bladder as:

• difficulty urinating (it takes longer) and interruption of urine output due to insufficient contractility of the bladder muscle - the detrusor;
• acute delay in micturition or enuresis;
• burning or pain when urinating;
• pollakiuria (a significant increase in the daily number of micturitions);
• discomfort or pain in the penis in men;
• sharp pains in the lower abdomen (above the pubic symphysis) with irradiation to the groin and perineum, as well as dull pains when walking, squatting and bending over;
• hematuria (the presence of blood in the urine) of varying intensity.

Types and composition of bladder stones

Depending on the etiology, the types of bladder stones are divided into primary (which, as noted above, are formed from salts of concentrated bladder urine residue directly in the bladder cavity) and secondary, that is, kidney stones in the bladder (which continue to increase).

There can be one stone - solitary, or several stones can form at once. They differ in shape and size, and, of course, in their chemical composition. Stones can be smooth and rough, hard and strong, soft and rather brittle. The range in which the size of stones in the bladder varies: from crystalline particles, almost invisible to the naked eye, to medium, large and giant. The largest bladder stone, according to Guinness World Records, weighed 1.9 kg and was discovered in 2003 in a 62-year-old Brazilian man.

Urologists determine the chemical types of stones by considering the composition of bladder stones.

Salts of oxalic acid in oxalate stones - calcium oxalate monohydrate (wevvelite) and calcium oxalate dihydrate (weddellite).

Urate stones in the bladder form urate salts of uric acid (uric acid potassium and sodium) that precipitate as pleomorphic crystals in acidified urine (pH

Phosphate salts - calcium phosphate, magnesium phosphate (magnesium), ammonium phosphate and ammonium carbonate - are part of phosphate stones, the formation of which is favored by alkaline urine (with a pH> 7).

Struvite calculi, consisting of magnesium and ammonium phosphates, are formed during repeated urinary tract infections with alkalinization of urine. They may occur ex novo or complicate renal lithiasis if pre-existing stones are colonized by the urea-degrading bacteria Proteus mirabilis. According to clinical data, they make up about 2-3% of all cases.

In many cases, salts of oxalic and uric acids are combined in the composition of the stones with the formation of urate-oxalate stones.

Complications and consequences

If left untreated, the main consequences and complications of bladder stones or kidney stones that have entered the bladder include chronic dysuria in the form of frequent and painful urination. And if the calculi completely block urine output (obstruction of the urinary canal occurs), then patients suffer from almost unbearable pain.

In addition, bladder stones provoke recurring bacterial infections and inflammation of the urinary tract - cystitis or urethritis.

Diagnosis of stones in the bladder

When referring to a urologist with urination problems, the patient must understand that the history and symptoms are not enough to make a diagnosis. The standard diagnosis of bladder stones includes urinalysis (general, pH, morning urine sediment, 24-hour biochemical, bacteriological) and blood (general, biochemical, and uric acid and calcium levels).

Only instrumental diagnostics can reveal the presence of stones, first of all, contrast fluoroscopy of the bladder in three projections. However, not all bladder stones can be visualized on x-rays: oxalate and phosphate stones are clearly visible, but urate stones are not visible due to the lack of contrast in conventional x-rays. Therefore, it is necessary to do an ultrasound of the kidneys, bladder and urinary tract.

They can also use voiding cystography during the examination; endoscopic cystography; urethrocystoscopy; computed tomography (which makes it possible to identify very small stones that were not noticed by other equipment).

Differential Diagnosis

Differential diagnosis solves the problem of distinguishing stones from diseases that can cause similar symptoms: recurrent infections of the bladder and urinary tract; chlamydia and vaginal candidiasis; overactive bladder; neoplasms of the bladder; endometriosis; epididymitis; diverticulitis; prolapse of the intervertebral disc with a blow to the spinal cord; instability of the pubic symphysis, etc.

Treatment of bladder stones

Increasing fluid intake can help small bladder stones pass. However, larger stones may require other treatments.

When treating bladder stones, you should remove the symptoms, as well as get rid of the stones.

Is it necessary to remove bladder stones? According to urologists, if you have bladder stones, they must be removed and as soon as possible, otherwise they will become larger. Small stones (up to 2 mm) can be eliminated by drinking plenty of water. However, one should take into account the fact that the male urethra has a curved configuration and a different inner diameter (with three zones of significant narrowing of the inner lumen), so it is unlikely to “wash” a stone with a transverse dimension of more than 4-5 mm. But in women, this is possible, since the inner lumen of the urethra is larger, and it itself is much shorter.

So, if the stones cannot be washed out of the bladder naturally, they still need to be disposed of: dissolved with medication or removed with lithotripsy.

Dissolution of stones in the bladder

The dissolution of stones in the bladder is carried out with the help of drugs that reduce the acidity of urine and make it more alkaline. This can also be done with sodium bicarbonate, that is, baking soda.

However, there is a risk of the formation of calcifications in the kidneys, as well as an increase in the sodium content in the blood (hypernatremia), which is manifested by general dehydration, weakness, increased drowsiness and convulsions. In addition, overly aggressive alkalinization can cause calcium phosphate to precipitate on the surface of an existing stone, rendering further medical therapy ineffective.

So, to reduce the acidity (alkalinization) of urine, drugs such as:

• Potassium citrate (potassium citrate), which can cause nausea, belching, heartburn, vomiting, diarrhea, and hyperkalemia with consequences such as muscle weakness, paresthesia and cardiac arrhythmia up to heart block.
• Oxalite C (Blemaren, Soluran, Uralit U) - 3 g two to three times a day (after meals).
• the diuretic drug Diakarb (Acetazolamide, Dehydratin, Diluran, Neframid, Renamid and other trade names) increases diuresis and quickly makes urine alkaline (pH 6.5-7.). But it is used no longer than five days, taking a tablet (250 mg) twice a day with an interval of 8-10 hours. The drug is contraindicated in patients with acute renal failure, diabetes mellitus and low levels of potassium in the blood.

Medications can help dissolve only urate (uric acid) stones and reduce the amount of calcium in the urine (so that it does not settle in crystals). Cystenal in the form of a solution (contains tincture of madder root and magnesium salicylic acid) - three to five drops are taken up to three times a day (30 minutes before meals); At the same time, you should drink more liquid (up to two liters per day).

Cyston also refers to herbal remedies. It is used for oxalate stones less than 10 mm in size - two tablets three times a day (after meals), the course of treatment lasts three to four months.

Rovatinex, containing terpene compounds, is used to dissolve calcium salts - three times a day, one to two capsules (for a month). Side effects are possible, which are manifested by a feeling of discomfort in the stomach and vomiting.

And the drug Allopurinol, which reduces the synthesis of uric acid, is intended to reduce the recurrence of the formation of renal calcium stones in patients with elevated levels of urate in the blood serum and urine.

With stones in the bladder and kidneys, vitamins B1 and B6 are needed, as well as magnesium preparations (magnesium citrate, Solgar, Magne B6, Asparkam, etc.), since this microelement prevents the crystallization of calcium salts contained in urine.

Removal of stones from the bladder

Modern methods used in urology to remove stones from the bladder are based on ultrasound and laser technologies and do not require open surgery.

Contact lithotripsy of bladder stones is performed endoscopically - by direct contact of the lithotripter with stones. This method involves the use of different techniques provided by different equipment) In particular, lithotripsy or crushing stones in the bladder with ultrasound allows you to destroy stones into small (up to 1 mm in size) parts with their subsequent removal from the bladder cavity using forced diuresis. The procedure is performed under regional or general anesthesia.

With contact laser cystolitholapaxy, the crushing of a stone in the bladder by a laser is also carried out endoscopically, but with transuretal access under general anesthesia. The holmium laser copes with the most dense calculi of any composition and significant size, turning them into dust particles, which are then washed out of the bubble.

The non-contact method - remote lithotripsy of bladder stones (shock wave) - consists in the action of ultrasonic pulses directed to the stones through the skin on the abdomen or lower back (localization is specified and the whole process is controlled by ultrasound). The stones must be broken down to a state of fine sand, which then comes out with urination, enhanced by the appointment of diuretics.

Among the contraindications for crushing stones, urologists call urethral stenosis, inflammation of the urinary tract, bleeding and malignant neoplasms in the pelvis.

Some stones are so large that they may require surgical treatment in the form of an open cystotomy. That is, an incision is made in the abdominal wall above the pubis and the bladder is dissected, and the stones are removed manually. This surgical removal of bladder stones is performed under general anesthesia and requires catheterization of the bladder through the urethra. Possible side effects of this operation: bleeding, damage to the urethra with scarring, fever, secondary infection.

Alternative treatment

In most cases, folk remedies for bladder stones include home remedies to prevent their formation. Recommend:

• drink orange and cranberry juice;
• take after dinner a decoction of grape leaves (25 g per glass of water), with the addition of 20-30 ml of grape juice;
• daily on an empty stomach drink a tablespoon of fresh onion juice or juice from parsley root and black radish (mixed in equal proportions);
• every day drink a decoction of dried leaves, flowers and fruits of prickly hawthorn with the addition of a teaspoon of lemon juice per 200 ml of decoction;
• for phosphate stones in the morning and evening, take apple cider vinegar (a tablespoon in half a glass of water).

No studies have confirmed that herbal treatment can break down bladder stones. However, some medicinal plants are included in pharmaceutical formulations.

With phosphate stones, phytotherapists recommend using madder root in the form of a 10% alcohol tincture (20 drops twice a day, after meals). And if the stones are uric, it is advised to drink a glass of decoction from calendula flowers once a day. The fruits (seeds) of the plant of the umbrella family ammi tooth (in the form of a decoction prepared from them) relieve spasms of the urinary tract, which facilitates the release of small stones, but when using this plant, you should drink plenty of water (up to two liters per day).

Knotweed (highlander), due to the presence of silicon compounds in it, helps dissolve calcium in the composition of stones. The decoction is prepared at the rate of - a tablespoon of dry grass per 200 ml of water; drink three times a day, 30-40 ml (before meals).

Diuretic herbs such as dandelion leaves, horsetail and stinging nettle are also used.

Diet and nutrition

Since urine is a waste product of the body's metabolism, diet and nutrition can correct its composition by limiting the use of certain foods that increase the level of uric acid salts (urates), oxalates (oxalic acid salts), or phosphate salts (phosphates).

If the bladder stones are composed of oxalates, you should reduce the use of all nightshade crops (potatoes, tomatoes, peppers, eggplants) and legumes, nuts. And it is better to completely refuse sorrel, spinach, rhubarb and celery. More information in the material - Diet with oxalates in the urine

Dietary recommendations in the case of phosphate stones refer to foods that contain a lot of phosphorus and calcium, since it is their combination (with an excess of both nutrients) that leads to the formation of insoluble calcium phosphate. So all dairy and sea fish, as well as lentils and soybeans, green peas and broccoli, sunflower and pumpkin seeds, pistachios and almonds are not for such patients. Although phosphorus is one of the substances used by our body to maintain a normal pH level.

Urolithiasis is characterized by the formation of stones (stones) in the human urinary tract. Formations in the bladder are often formed in the stronger sex after 45 years of age against the background of diseases of the prostate gland or urethral structures. The disease is widespread in African, less often in the Middle Eastern countries. Europe suffers from the disease a little less often, but stones in the bladder are relatively common in men.

Follow the preventive recommendations, if you find unpleasant symptoms, visit the doctor immediately. Diagnosed in time, the disease is treatable, the prognosis is almost always positive. Lack of therapy threatens the development of numerous complications, up to death.

Factors affecting the formation of the disease

Science does not fully know the exact factors that provoke the formation of stones in the bladder in the stronger sex. Scientists identify a number of possible causes of the disease. The most negative factor is non-compliance with the water-salt regime. The accumulation of excessive amounts of salts leads to improper functioning of the urinary tract in the body.

The accumulation of salts is not always associated with excessive consumption of the product in food. A pathological process can form against the background of a violation of the excretion of sodium by the kidneys, the course of diseases of the genitourinary system.

Provoking factors include:

• abnormal structure of the urinary tract, which contribute to the stagnation of urine in the bladder;
• inflammatory processes occurring in the bladder;
• the presence of small stones in the upper urinary tract. Small stones are able to pass into the bladder, get stuck there, begin to increase in size;
• foreign bodies (catheters, suture material). All objects can migrate into the bladder, disrupt the outflow of urine;
• prostate cancer, oncological diseases in the body (radiation therapy adversely affects).

The root cause of the appearance of stones in the bladder is an important aspect. Before removing stones, doctors will often prescribe a course of therapy that eliminates the cause of the pathology (for example, they treat metabolic disorders, eliminate infectious diseases).

Signs and symptoms

The presence of salt formations in the bladder in men is manifested by pain in the lumbar region, the appearance of blood in the urine. Symptoms are aggravated during physical exertion, sudden movements. A change in body position often leads to acute pain, which is associated with the movement of stones. During this process, the patient feels pain of varying severity. In men, the pain integrates into the genital area. If the stones block the ureter, this leads to the accumulation of urine,.

Attacks of acute pain are often accompanied by fever, sometimes chills. Unpleasant sensations disappear if the stone has changed its position or come out completely. To the above signs, a change in the shade of urine, its consistency is added, the smell also becomes sharply unpleasant. A strong pain attack will be relieved by analgesics, in severe cases, call an ambulance.

Classification of the pathological process

Calculi in the bladder can be of different sizes, shades, differ in chemical composition. Small stones are called, medium - macroliths, large - solitary formations.

Specialists distinguish many classifications, but the composition of calculi in the bladder plays an important role in treatment:

• oxalate. Stones are formed from oxalic acid, they have a rough surface, a brown tint. Formations scratch the urinary tract, stain the urine red;
• phosphate. Calculi are formed from phosphate acid, they are quite fragile, have a gray tint. Often such stones are formed as a result of metabolic disorders;
• urate. The formation process is triggered by uric acid. Urate stones are smooth, do not injure the mucous membranes. Such formations appear in residents of hot countries against the background of constant dehydration;
• protein. They include protein compounds, are formed against the background of malnutrition.

Important! Each type of calculus requires specific treatment, a special diet. It is impossible to independently know the chemical composition of stones. Diagnosis is carried out by an experienced physician, the physician prescribes the appropriate course for eliminating the pathology. Improper treatment leads to aggravation of the situation, the appearance of complications.

Diagnostics

To prescribe the appropriate therapy, the physician must make the correct diagnosis. Research includes a lot of activities:

• general analysis of urine, blood of the victim;
• Ultrasound of the bladder, other nearby organs;
• an x-ray of the bladder often helps to make the correct diagnosis;
• intravenous urography.

Don't get used to bouts of pain, bladder stones are treatable. The lack of medical care leads to an inflammatory process in the kidney, disruption of the organ, and the development of renal failure. In the worst case, you can lose a damaged kidney.

Effective Treatments

Removal of stones from the bladder in men is a long process that requires an integrated approach. Depending on the chemical composition of the stone, the individual characteristics of the patient, the doctor prescribes therapy. It includes the use of medicines, folk remedies, adherence to a special diet. In some cases, surgery is required.

Medical therapy

To reduce pain, analgesics are used, and antispasmodics help to facilitate the process of removing stones from the bladder.

The following medications are capable of dissolving stones:

• Allopurinol. Influences the process of formation of uric acid in the patient's body, reducing the chances of stones, promotes the dissolution of existing urate stones. Also, the drug is actively used for the treatment of gout, so the drug copes with stones in the bladder if their etiology is not clear;
• Pennicylamine. Used to dissolve cystine stones. The effectiveness is ensured by stopping the excretion of cystine in the urine. Prolonged use of the drug threatens with constant dry mouth, skin rash, tinnitus;
• Captopril. Designed to treat high blood pressure, but does an excellent job with cystine stones. Side effects include: dizziness, a slight decrease in the patient's weight, skin rashes.

Medicines should not be used for high blood pressure, course, pregnancy, the presence of other contraindications.

Folk remedies and recipes

Natural drugs do an excellent job of removing various salt formations from the urinary tract of the stronger sex. The key to successful treatment is the regular use of folk remedies, their proper preparation.

Effective Recipes:

• onion tincture. Fill half a jar with chopped onions. Fill the vegetable to the top with alcohol or vodka, let it brew for ten days. The resulting remedy, take two tablespoons twice before meals. The duration of therapy depends on the size of the formations in the bladder;
• sunflower roots. Pre-rinse the raw materials thoroughly, chop finely, pour into a saucepan, pour three liters of boiling water, cook for five minutes. Raw materials are enough to prepare three portions of the broth, drink the filtered broth half a cup three times a day for one month;
• tangerine therapy. The method is allowed for patients who are not prone to allergies. During the week, consume up to two kilograms of tangerine. Take a week break, repeat the treatment manipulations;
• vegetable juice. Three times a day, drink 100 grams of carrot / cucumber / beetroot juice. You can prepare a mixture of juices, drink twice a day. The course of therapy lasts no more than two weeks, prolonged treatment can lead to the development of an allergy to the selected components of the drug.

Consult your doctor before starting therapy if allergic reactions occur, choose a different traditional medicine recipe.

Go to the address and read about the rules of nutrition and diet for glomerulonephritis.

Surgical intervention

In especially severe cases, the patient is shown surgical intervention. Recently, many techniques have appeared that allow crushing stones without resorting to a scalpel. If the size of the calculi does not exceed 20 mm, ultrasound or a laser is used. The procedure helps to destroy stones in all organs except the bladder.

To solve this problem, the contact method is used, using a special tool (cystoscope): a thin puncture is made in the right place, stones are crushed, and the cavity is washed with a special liquid. Large stones, the presence of contraindications to crushing stones obliges doctors to carry out a full-fledged surgical intervention.

Useful tips will help prevent the re-formation of stones in the bladder in the stronger sex:

• treat cystitis in a timely manner;
• avoid hypothermia;
• give up bad habits;
• follow a special diet prescribed by a doctor;
• visit a urologist once a year, treat prostate pathologies in a timely manner. For men over fifty years of age, preventive examinations should take place twice a year;
• increase the amount of fluid consumed (at least one and a half liters per day). The specific dosage depends on the water-salt balance of the patient, is calculated on an individual basis.

Stones in the urinary system are a serious problem that needs attention. Negligent attitude to health threatens with complications, even the loss of a kidney. Visit the doctor in time, monitor the condition of the body.

Find out more about the causes of the formation of stones in the bladder and the methods of treating the pathology after watching the following video:

Urolithiasis is a pathology that is better known as urolithiasis. A characteristic symptom of the disease is the formation of stones (calculi) in the organs of the urinary system.

Quite often stones appear in the bladder. Pathology manifests itself in patients at different ages. Stones come in a wide variety of sizes, shapes and textures.

As a rule, the disease is easy to identify by very specific signs, however, there are cases when the patient did not experience any discomfort from the presence of stones in the body.

In medicine, stones in the bladder are classified according to several criteria.

• Age category. The older the patient, the more uric acid in the composition of the stones; in children, the stones contain mainly uric acid in crystals, calcium oxalates and phosphates.
• Quantity. You can diagnose one stone (single) or several (multiple).
• The size. There are stones very small, as well as reaching the size of the bladder.
• Structure. Stones can be soft or hard.
• Surface. There are stones that are smooth, pebble-like in shape, and more dangerous - with sharp spikes.

Reasons for education

1. infravesical obstruction. Under such a complex name, a pathology is hidden, due to which the bladder does not perform its functions. As a result, the natural outflow of urine is disturbed, its concentration increases, which contributes to the formation of salt crystals. In the future, it is they who are transformed into stones. As a rule, this cause of the development of pathology is typical for people of advanced age.
2. Disturbed connections of the bladder with the central nervous system. According to statistics, in the case of injury to the spinal cord, as well as a neurogenic bladder, stones form over eight years.
3. inflammatory processes. Any inflammatory processes affecting the bladder contribute to the development of urolithiasis; patients who undergo radiation therapy are at risk.
4. The presence of foreign bodies in the bladder. These can be catheters, stents, sutures, anti-fertility drugs that have entered the bladder.
5. Various defects. For example, pathologies of the muscular membrane, protrusion of the mucous membrane, prolapse of the bladder (typical for women).
6. Surgical interventions, mainly with the transfer of tissues.
7. Stones that formed in the kidneys, but due to certain reasons penetrated into the bladder.

The outflow of urine caused by metabolic disorders is not the cause of the formation of stones in the bladder.

Symptoms of stones in the bladder

As a rule, urolithiasis has specific symptoms, however, sometimes the patient does not even suspect the presence of a stone in the body. That is why in order to clarify the exact picture and determine the correct diagnosis, it is necessary to use special medical equipment.

Most often, in the presence of stones in the bladder, patients experience the following symptoms:

• pain syndrome in the lower abdomen, which spreads to the pubic and inguinal zones;
• frequent and sudden urge to urinate, especially at night;
• cramps and pain when urinating;
• the presence of blood in the urine.

In some cases, such a symptom is possible: a sharp cessation of urination and the appearance of acute pain that affects the genital area, lower back, abdomen and thighs. Similar discomfort can occur during physical exertion. In children, a symptom of the presence of stones in the bladder is urinary incontinence and uncontrolled erection, accompanied by pain.

Pain in the lower abdomen is a fairly common symptom of many diseases in women, ranging from kidney disease to diseases of the reproductive system. What could be the reasons for this state of affairs? Diagnosis of diseases, treatment and possible complications.

Read more about how to recognize the symptoms of kidney disease.

Ultrasound of the kidneys is the most common method for detecting diseases. It is with this method that a complete examination of the patient begins. Read here about how the study is carried out and what indications for its conduct exist.

Diagnostics

An accurate diagnosis can be made already at the initial stages of the development of pathology. For the diagnosis of urolithiasis, the following examinations and tests are necessary.

1. General urine analysis.
2. General and biochemical blood tests, during which inflammatory processes in the bladder and any changes in the composition of the blood can be detected.
3. Ultrasound examination of the kidneys, which allows to determine the degree of anatomical changes that are provoked by the stone.
4. Excretory urography - a contrast solution is injected into the patient's vein and then an x-ray of the urinary system is taken. During the diagnosis, the main parameters of stones and their location in the body are determined. However, it should be borne in mind that not all stones are capable of transmitting x-rays, such stones will not be visible on x-rays.
5. Radioisotope nephroscintigraphy - a special medical solution is injected into the patient's vein, which is subsequently excreted through the kidneys. Then the specialists scan the urinary system using medical equipment.

Ultrasound - a large stone in the bladder

Treatment

1. Conservative treatment. It is prescribed in the case when the size of the stones is less than 3 millimeters. In this case, the patient is offered drug therapy and therapeutic nutrition. The main goal of drug treatment is the dissolution of stones and the elimination of an acute attack of the disease. To combat pain, drugs such as No-shpa, Baralgin, Papaverine, Spazmalgon are prescribed. Medicines are presented in a wide range in any pharmacy. The drugs act on the walls of the ureter, relaxing it and thereby activating the mobility of the stone. However, antispasmodics can only eliminate pain, but cannot save the patient from the main cause of the disease - the stone.
2. Removal of the stone with a cystoscope. In this case, a special metal tube equipped with optics is inserted into the patient's urethra. Examination of the bladder and the mouth of the ureters. Then, a tube - a stent - is inserted into the opening of the ureter, where the pathology is found, which resumes the natural outflow of urine.
3. Operational intervention. This is the most radical treatment for urolithiasis. Surgery is necessary when the stone grows to a large size. As for the incision, it is performed in the place where the stone is diagnosed. After removing the calculus, specialists drain the area to remove urine that seeps through the bladder wall.

In addition, the procedure for crushing calculi - remote wave lithotripsy - is also considered an operative method of treatment. In the process of manipulation, the stones are crushed and then brought out.

When choosing a drug of the same name in different dosage forms, it is better to give preference to injections, since intravenous and intramuscular administration of the drug is more effective.

Recovery period

In the future, the patient needs to undergo a course of treatment with mud and mineral waters. The best resorts for this purpose are Truskavets, Morshyn.

Health food

Regardless of the location of stones in the body, doctors prescribe therapeutic nutrition to patients - the so-called table number 7.

The main principles of such nutrition include the following points:

• the minimum amount of salt;
• the minimum amount of fatty foods;
• exclusion of alcohol;
• exclusion of spices and other concentrated foods.

Treatment with folk methods

According to experts, treatment with folk methods is ineffective, however, quite often, horsetail tincture is prescribed to patients. This tool promotes the resorption of stones.

Horsetail tincture quickly and strongly destroys tooth enamel, so it is better to use it through a straw.

Prevention

Prevention of pathology involves a set of measures aimed at preventing the appearance of stones in the bladder:

• Correction of the diet: the exclusion of fatty, salty, smoked foods, spices.
• Maintaining water balance - the daily rate of fluid intake is at least one and a half liters, with sufficient water intake, the patient goes to the toilet at least six times during the day.
• The last preventive measure primarily concerns people who lead a sedentary lifestyle - it is necessary to play sports.

Prognosis after stone removal

After completion of treatment, the patient should be regularly observed by a urologist, undergo a metabolic examination of the kidneys and an ultrasound examination at least once every six months.

With the elimination of all the causes that provoked the development of pathology, the prognosis is favorable.

But, if the causes of the disease remain unresolved, a relapse is quite likely - the reappearance of calculi in the bladder, which will require repeated treatment.

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At the moment I only have sand in my bladder. But it made me think about my lifestyle already. The doctor advised me to follow a diet, take some medications and see a doctor.

Bladder stones, or cystolithiasis, is one of the forms of urolithiasis. It is characterized by the deposition in the cavity of the organ of salt stones of different composition. Their differences are due to differences in the mechanism of formation and localization in the organ. They differ in parameters, quantity, chemical composition, surface type, color, shape and density.

Reasons for the formation of stones

Bladder stones in women appear at any age, while in men they form either in childhood due to the narrowness of the urethra, or in the elderly due to prostate adenoma.

Today, medicine cannot accurately indicate the causes of stone formation in the bladder. Many experts adhere to the main multifactorial theory, which explains the process of cystolithiasis with many factors.

Here are the main ones:

Bladder stones vary in different ways:

• sizes;
• form;
• surfaces;
• composition.

In composition, they can be:

• calcium. These are hard, hardly soluble, rough stones. Among them, subgroups are distinguished: oxalate, consisting of salts of oxalic acid; phosphate, formed by salts of phosphoric acid, easily amenable to crushing.
• Urate, or uric acid, are formed by salts of uric acid. They are smooth and do not injure the urinary tract mucosa.
• Struvite (formed against the background of bacterial cystitis).
• Cystine (formed against the background of cystinuria). They have a hexagonal shape.
• Protein (formed from protein in the urine sediment).

Single-component stones are rare. They often have a mixed composition: urate-phosphate, phosphate-oxalate, etc.

According to the etiological basis, stones in the bladder can be primary, that is, they immediately formed in it. Secondary stones enter it from the kidneys and ureters.

Symptoms of bladder stones

Symptoms of bladder stones are varied, but they cannot be called characteristic only for this disease. If the stone moves into the bladder and has not yet descended into it, then the signs of the disease appear in pains of varying strength. It can be pain in the lower abdomen in the suprapubic region, in men, pain can radiate to the perineum and penis. It increases with urination, with a change in body position.

If the stone has formed in the bladder itself or has already safely descended into it along the ureter, then the symptoms will be different. Pain is mild, aggravated by urination or during sexual intercourse. You can determine the presence of a stone at the time of blocking the mouth of the urethra. Its sign may be the interruption of the urine stream or its complete overlap. Acute urinary retention can be replaced by its incontinence if there is a non-closure of the internal sphincter of the bladder due to a stone blocking it.

Diagnostics

The main diagnostic methods for bladder stones are:

• general urine analysis;
• cystoscopy.

Additional methods:

• Rg-gram of the urinary tract;
• cystogram.

Excretory urography, previously one of the main diagnostic methods, is now receding into the background. It helps to determine the condition of the urinary tract, the presence of stones, bladder diveticulosis (multiple protrusions of the walls of the organ, in which urine accumulates and stagnates). The radiopacity of stones is affected by their composition, primarily calcium content.

Now the main diagnostic method is an ultrasound examination of the organ. It is more informative, accurate, fast and non-traumatic for the patient. For ultrasound, there is no need for intravenous catheterization of the patient and the introduction of a contrast agent. Ultrasound examination identifies hyperechoic formations in the bladder with an acoustic shadow, moving in the organ cavity in different positions of the patient's body.

An even more accurate diagnostic study is computed tomography. Its essence is that a series of body shots are taken in different projections. This makes it possible to most accurately establish the location, size and localization of stones.

A comprehensive diagnosis also includes instrumental and laboratory research and a carefully collected anamnesis. A general urine test shows leukocytes, erythrocytes, bacteria and salts in it. Cystoscopy allows you to see through the endoscope the condition of the mucous membrane of the walls of the bladder, the presence of tumor formations and calculi.

How to treat stones

Treatment can be divided into relief of an acute attack and basic therapy. In the elimination of an acute attack, antispasmodics are effective. They have a relaxing effect on the walls of the bladder, relieving pain. But antispasmodics do not eliminate stones from the organ, so sooner or later basic therapy is applied.

Small stones and sand are removed from the bladder on their own with urine. If large stones are not found during the examination, then conservative treatment is performed. It consists in prescribing medications that alkalinize urine, and following a diet aimed at curbing stone formation. Medical treatment includes:

• antispasmodics and analgesics;
• preparations with goldenrod;
• antibiotics.

With urate stones, litholytic therapy is carried out, the dissolution of calculi by taking special preparations that allow you to dilute urine. Today, minimally invasive treatment methods are used in urology. Their advantage is less blood loss, less stress for the patient, fewer complications and a shorter recovery period. With a large number of stones or with their large sizes, the treatment of stones in the bladder consists in fragmenting and removing them from the organ by contact or remote method (lithotripsy), or by a surgical method during an open operation - cystolithotomy.

The use of a remote method using ultrasound or a laser is possible if the diameter of the calculus does not exceed 3 cm. An open surgical operation is performed if another method could not remove the stone and turned out to be ineffective. The most effective are endoscopic methods:

• Cystoscopywhen a special apparatus is used - a cystoscope. It is injected through the urethra into the bladder. This is a metal tube of a certain diameter with an endoscope. With its help, the mucous membrane of the walls of the bladder and the mouth of the ureters is examined. A cystoscope is used not only to examine the walls of the bladder, but also to introduce instruments through it, for example, a lithotripter - a stone crusher - and fragmentation of the stones found is carried out.
• Transurethral cystolitholapaxy. Crushing of the stone is carried out after cystoscopy. The destroyed stone is removed through a cystoscope. This method is used in the treatment of adult patients. Most patients with bladder stones are men. The main factor in cystolithiasis is prostate adenoma. Therefore, the removal of stones from the bladder in men is done along with the removal of an adenoma. This operation is also performed endoscopically.
• Percutaneous suprapubic litholapaxy used in the treatment of children. The method is fast and safe for the patient, allows you to crush the calculus.
• Open cavity surgery used very rarely. The indications for it are the large size of the calculus, which cannot pass through the urethra even after crushing.

Indications for surgical treatment:

• recurrent cystitis;
• acute urinary retention;
• lack of effect from other methods of therapy;
• hematuria (blood clots in the urine).

Operative methods of treatment are carried out under different types of anesthesia. The choice of method of anesthesia depends on the severity of the patient's condition and the decision of the anesthesiologist.

Recovery period

During this period, catheterization of the bladder and the administration of antibacterial drugs are necessary. On average, its duration is 5 days. For another 3 weeks after the hospital, the patient is required to be monitored and controlled with an ultrasound of the bladder, metabolic monitoring. Patients are transferred to the diet table number 7 with the restriction of salt, fat, alcohol, spices and other products that can cause stone formation. After surgical treatment for the extraction of stones, there is a certain percentage of complications:

• postoperative infection;
• damage to the wall of the bladder;
• bleeding and bladder tamponade.

But the percentage of these complications is insignificant. The effectiveness of transureral cystolitholapaxy comes out on top among other methods of treating this disease.

Treatment with folk remedies

Treatment of bladder stones with folk remedies will only work if there are small stones and sand that you can get rid of yourself. Recently, horsetail tincture has been successfully used for this purpose. Its dissolving properties in relation to urinary stones were recognized even by official urology. But in more complex variants of the disease, the use of horsetail tincture is impossible.

Forecast and prevention

The prognosis of the disease depends on what factors disrupt the normal outflow of urine. If this factor is eliminated, the prognosis is favorable, although according to observations of patients who underwent surgical removal of stones from the bladder, relapses of the disease occur in 50% of patients within 10 years after surgery. Therefore, it is so important to eat rationally even after surgery to remove stones from the bladder. Knowing the tendency of stone formation in your body, you can apply an appropriate diet that will help curb this process. For example, here are the types of diets that can be used with stones of the following composition:

• calcium - diet with salt restriction;
• oxalate - restriction of chocolate, coffee, tea, meat, nuts;
• cystine - restriction of protein foods, especially meat;
• struvite - avoiding any urinary tract infections.

So, following the recommendations of the urologist, leading an active lifestyle, eliminating bad habits, constantly monitoring the condition of the urinary tract through annual preventive examinations, the patient after the removal of stones from the bladder can lead a full quality life for many decades.

Today, people quite often find symptoms of bladder stones in themselves. In most cases, sand and larger calculi form in the kidneys and are passed into the bladder with urine. In such cases, they talk about the presence of secondary stones.

But due to the occurrence of certain pathologies, in particular, urethral strictures, adenoma or prostate cancer, stones can form directly in the bladder cavity and be called primary.

Symptoms

How the disease will manifest itself depends on the nature of the stones and their size. Most often in patients there are:

• Oxalates. These formations have a rough surface with protrusions and are distinguished by considerable hardness. Therefore, moving along the urethra or moving along the bottom of the bladder, they can damage the delicate mucous membranes, which causes pain and blood in the urine.
• Phosphates. Calculi of this nature are softer and more fragile than oxalates, although, like oxalates, they are formed from calcium salts. Their presence may be indicated by the presence in the urine of light flakes with a loose consistency, interruption of the urine stream during urination, and pain in the lower abdomen.
• Urates. Since these stones have a smooth surface, they very rarely cause damage to the mucous membranes of the organs. Therefore, patients usually become aware of their presence after passing a urine test.

Also, in rare cases, patients may form other types of calculi. It:

• struvite;
• cystine stones;
• mixed formations.

Types of bladder stones

Thus, the main signs of stone formation are:

• pain in the lower abdomen, which can radiate to the genitals or perineum;
• cramps and increased discomfort during urination;
• increased urge to urinate;
• staining of urine with blood in a dark color;
• cloudy urine;
• interruption of the urine stream.

Moreover, the appearance of another urge to urinate immediately after or during a bumpy ride, fast walking or running, performing physical work, for example, associated with lifting and carrying heavy loads, etc. can act as a symptom of sand in the bladder. If the patient's condition is complicated by the addition of an infection, then there may also be a violation of his general well-being, that is:

• weakness;
• temperature rise;
• the appearance of headaches or discomfort in the joints;
• loss of appetite, etc.

Attention! Sometimes patients cannot completely empty their bladder until they change their position or make some movement, because the stone can block the entrance to the urethra and thereby prevent the exit of urine from the bladder.

Nevertheless, in some cases, the disease is completely asymptomatic, and it is possible to diagnose suspension in the bladder only with the help of special examinations, in particular, ultrasound and OAM.

Treatment

Bladder stones can be treated by:

• Conservative therapy, which includes following a diet specially designed by the doctor and taking medications to dissolve calculi, increase diuresis, eliminate signs of inflammation, prevent the development of infectious complications, etc.
• Removal of stones.

At the same time, the treatment of sand in the bladder is usually not carried out, with the exception of diet, since it can be excreted from the body along with urine through the urethra on its own. It is thanks to proper nutrition that the patient can get rid of already existing microliths and prevent the formation of large stones that require prompt removal.

It depends on the care of the diet whether new stones will form or not.

For each patient, the diet is developed by the doctor individually, taking into account his individual characteristics. But the determining factor in compiling the list of prohibited foods is the type of stones formed, since the main tasks of changing the diet are to correct the composition of urine and shift its pH in one direction or another.

• alcohol;
• salt;
• spices;
• chocolate
• fatty food.

Depending on the nature of the stones found, this list is supplemented with other food products. For example, in the presence of phosphorus stones, it is not recommended to consume dairy and sour-milk products. The mildest diet is prescribed during the formation of urates. These same formations are the easiest to dissolve.

Important: almost all patients are shown the use of large volumes of liquid, but the choice of mineral waters must be approached carefully. It is best to discuss with the doctor what kind of mineral water the patient should drink and in what quantity, so as not to aggravate the situation.

Removal of stones from the bladder is carried out by several methods:

• Crushing of stones with subsequent removal of fragments using a cystoscope. As a rule, the procedure is carried out using ultrasound or a laser. But its implementation is possible only in the presence of formations whose dimensions do not exceed 3 cm.
• An open surgical intervention that involves making an incision in the suprapubic region and the wall of the bladder, followed by manual removal of stones.

Surgical intervention in the presence of stones refers to heavy artillery and is used only with complete ineffectiveness or impossibility of all other procedures.

Attention! It is extremely important to follow a diet, even if the stones have already been removed in one way or another, as it is designed not only to contribute to their dissolution, but also helps to prevent the formation of new ones.