Main »
Urology
» Urolithiasis - Diagnosis, Causes, Treatment
15:49
Urolithiasis - Diagnosis, Causes, Treatment
Urolithiasis, causes kidney stones, renal colic causes, diagnosis of urinary stone disease, treatment of urolithiasis
Urolithiasis - a disease associated with metabolic disorders in the body, which as a result of metabolic formation of kidney stones and urinary tract. Recently, due to changes in nutrition, sedentary lifestyle, exposure to various environmental hazards urolithiasis has become increasingly common.
The stones in urolithiasis occur in all parts of the urinary system: in the cups, pelves of the kidneys, ureters, bladder and urethra. Most rocks appear in one of his kidneys, but can occur two-way process. The stone in the kidney or urinary tract may be isolated, but sometimes a patient may have a few stones. The value of the stones are very varied from small stones of about 1 mm, to the giant - more than 10cm in diameter. Some stones can be patient for a long time, not increasing in size, the other for 6 months to grow large and fill the entire pelvis and calyx in the bud. One-third of patients re-formed rocks, and the disease takes the recurrent nature. At present, the cause of stone formation is not fully understood.
It is believed that the causes of urolithiasis set of external and internal factors: external causes: eating habits, physical and chemical properties of water, hazardous working conditions, lack of exercise, lack of food vitamin A, and B vitamins, the use of certain drugs (sulfonamides, excessive intake of ascorbic acid - vitamin C) internal causes of the urinary system: abnormal development of the kidneys and urinary tract (narrowing of the urinary tract for various reasons, only one kidney, horseshoe kidney, anomalies that lead to a breach of the outflow of urine), urinary tract infections internal causes of the entire body: the state of deficiency of any of the enzymes, leading to disruption of normal metabolism, diseases of the gastrointestinal tract, prolonged state of immobility (immobilization of fractures).
On the structure of the stones are:
uric acid (urate) - they are composed of uric acid salts have a yellow-brown color, dense, smooth surface
oxalate - these stones are composed of salts of oxalic acid, they are black-brown solid with a rough surface, which could be spikes
phosphate rocks are soft, grayish-white color, they easily crumble
Mixed stones - the inside of these rocks is called the core and is formed from one type of salt, and the shell of the other
cystine stones are the hardest to have a smooth surface.
Urolithiasis in Urolithiasisa patient at the beginning of the disease may not manifest itself, even if the stone is already there. But in most cases kidney stones begins with an attack of renal colic.
Renal colic - an attack of severe pain in the lumbar region. If the stone is located in the lower ureter, pain may occur in the abdomen and give to the groin. The pain comes on suddenly, including overall health, any time of day. The change in body position has no effect on the strength of pain. Patients are usually restless, constantly moving, trying to find a posture in which the less it hurts. Sometimes there is nausea and vomiting. Often frequent urination in small quantities of urine.
The cause of renal colic - blockage of the ureter stone and a sharp increase in pressure in the renal pelvis causing pelvis stretch. In the wall of the pelvis a lot of pain receptors, so the pain is usually severe. If the size of the stone is less than 6.5 cm, the stone itself often departs from the urine. For large amounts of stone, or if, due to restrictions of the urinary tract, or other causes is a long stone in the urinary tract and continues to violate the flow of urine, pressure in the renal pelvis remains elevated for a long time and increases all the time, this situation can lead to dysfunction and even the death of the kidney.
Diagnosis of urolithiasis is established using laboratory tests. The urine found microhematuria (a small amount of red blood cells), a large amount of salt, less white blood cells. Be sure to spend an ultrasound of the kidneys and bladder, which allows you to see the stone in any area of the kidney, the lower third of the ureter (upper and middle ureter is not available for ultrasonography) and bladder. When X-rays are the projections of the shadow of the stone in the urinary tract. But some stones (uric acid, cystine, xanthine) on chest radiographs are not visible. For an accurate diagnosis performed excretory urography - a study using contrast agents, which helps to accurately set the blockage of the urinary tract. Sometimes the computer and carry out magnetic resonance imaging. Treatment of urolithiasis.
Treatment of urolithiasis should be comprehensive. Stone from the urinary tract should be removed. For small pelvis or ureter stones prescribe drugs that activate urodynamics, self-discharge of stones, antibiotics and medication to dissolve the stones. If the size of the stone up to 0.5 cm appoint tsistenal, artemizol, ennantin, avisan. If the stone does not pass on their own, various methods for fragmenting the stone. In renal colic used thermal procedures (hot water bottle, bath), analgesic agents, antispasmodics, procaine blockade. If the stone can not be removed by conservative measures, or remote sensing methods, and further finding of the stone in the urinary tract threatens the emergence of complications from kidney surgery is performed. After removing the stones from the urinary tract the patient should receive prophylactic treatment, which largely depends on the type of stones. Assigned to diet and water regime, vegetable diuretics, a spa treatment.
