Urolithiasis (urolithiasis) - a disease that occurs as a result of metabolic disorders in which the urine formed insoluble precipitate in the form of sand (up to 1 mm in diameter) or rocks (from 1 mm to 25 mm and more). Stones are deposited in the urinary tract, which disrupts the normal flow of urine and is the cause of renal colic and inflammation.
According to medical statistics, urolithiasis is second in frequency among all urological diseases and the third leading urologic diseases that lead to death. Urinary stone disease affects people of all ages, including children, but the main age group - people aged 25 to 45 years. The disease is more common in men than in women, but women often are diagnosed severe illness. It is also known that the stones are often formed in the right kidney than in the left, and approximately 20% of the pathological process involved in both kidneys.
Causes of kidney stones
In the occurrence of kidney stones plays the role of a number of factors, in this case before the end of the mechanism of formation of stones and its causes are not clear. It is known that the leading role is given to structural features of the duct system of the kidneys when renal anatomical structure itself contributes to stagnation. Thus for stone formation necessary also the influence of external factors, primarily, diet and fluid intake conditions. Also in the development of urolithiasis play the role of the urogenital system diseases, endocrine pathology (particularly diseases of the parathyroid glands, directly affecting the metabolic processes involving calcium), long-term use of certain drugs (sulfonamides, tetracyclines, glucocorticoids, aspirin, etc.).
Types of urolithiasis
Various metabolic disorders cause stone formation, differing in their chemical composition. The chemical composition of the stones is important, because it affects the medical tactics in the treatment of kidney stones, as well as correction of the diet for the prevention of recurrence.
In the urinary tract calculi are formed following:
- Stones based on calcium compounds (oxalates, phosphates, carbonates);
- Stones based uric acid (urate);
- Stones formed magnesium salts;
- Protein stones (cystine, xanthine, cholesterol).
The main share falls on the compounds of calcium (about 2/3 of all stones), protein stones are the least likely. Urata - the only group that is amenable to dissolution. These stones are often detected in the elderly. Stones consisting of magnesium salts, frequently accompanied by inflammation.
The stones in urolithiasis can be formed in any part of the urinary tract. Depending on where they are located, are the following forms of the disease:
- Nephrolithiasis - in the kidneys;
- Ureterolitiaz - in the ureters;
- Tsistolitiaz - bladder.
The symptoms of kidney stones
Urolithiasis initially asymptomatic. The first signs of urolithiasis detected either by accident during the test or during the sudden renal colic. Renal colic - a strong attack of pain, are often the main symptom of kidney stones, and sometimes the only, is the result of a spasm of urinary duct obstruction or stone.
Acute attack begins with severe pain, localization of which depends on the location of the stone. The pain is intense, it can give in the groin, abdomen, lower back. Urination becomes painful and frequent, the blood found in the urine (hematuria). Nausea and sometimes vomiting. The patient is desperately looking for a position that would bring relief, but this situation does not find. The attack of renal colic can pass with remission and exacerbation of pain and end either removing stones or colic subsided, or developed complications.
It should be noted that the severity of symptoms of urolithiasis is not always associated with the size of the stones. Sometimes concretions of small size, not exceeding 2 mm, can cause severe colic, whereas there are cases of severe kidney damage when multiple stones, fused staghorn in education do not lead to colic, and discovered by accident or when complications begin urolithiasis.
Diagnosis of urolithiasis
Diagnosis of urolithiasis occur on the basis of characteristic clinical picture of renal colic and ultrasound data. Informatively as computed tomography and magnetic resonance urography. Carry out a detailed analysis of urine, with functional tests (for Zimnitsky, Nechiporenko et al.). Be sure to urine culture. Radiography is now lost its leading position in the diagnosis of urolithiasis, but is still used as an additional method.
Treatment of urolithiasis
The attack of renal colic is removed using drugs antispasmodic and analgesic effect. The main treatment of urolithiasis is carried out in the absence of acute symptoms.
Urinary stone disease is considered a surgical disease, but urolithiasis caused by the formation of urate, can be treated with medication, taking medications that dissolve the stones. Other types of stones require mechanical removal.
Treatment of kidney stones by means of two basic methods: lithotripter and surgical. Remote shock-wave lithotripsy - effective treatment of urolithiasis in which stones in the urinary ducts are divided by a shock wave and then excreted in the urine. The method proved to be excellent, thanks to him, the indications for surgery in the treatment of urolithiasis significantly narrowed.
Operations by which the treatment of urolithiasis, divided into open and endoscopic, and on the organ and radical. Radical surgery is the removal of the kidneys, in the event that it has lost its function. The method of preference in the choice of surgical treatment of urolithiasis are endoscopic techniques that allow for the removal of stones without making an incision in the abdomen.
Prevention of urolithiasis
Prevention of urolithiasis is a prerequisite for the full treatment, as without relapses inevitable. The basis for the prevention of kidney stone disease is diet, normalizes metabolism and biochemical composition of urine and drinking regime. Diet urolithiasis produced depending on the chemical composition of the stones. Thus, when the power of oxalates exclude dairy products, chocolate, and for urate stones limit eating meat. An essential condition is the reception of a sufficient quantity of water - 1, 5 - 2L per day.