Kidney stones appear as a result of the deposition of harmful substances. They are the cause of, among others troublesome renal colic. Find out why they arise and what are the treatments for kidney stones?
Kidneysis a chemical plant operating at full speed around the clock. They filter the blood and separate harmful substances formed during metabolism from it. These substances are excreted outside the body with urine. Unfortunately, it also happens that some of them remain at the bottom of the renal calyx and form a sediment plate there. If it fails to crush itself and does not flow out with urine, more layers of sediment attach to it and start to formkidney stones . In most cases, kidneys are formed in the calyxes. From here, they can travel to the renal pelvis, ureters, andbladder.
Causes of kidney stones
Kidney stones are formed when the concentration of compounds from which deposits can form exceeds the so-called the threshold of solubility in the body. It is favored by hereditary tendencies, defects in the structure of the urinary system and its recurrent infections. The use of certain medications (e.g. corticosteroids), hyperparathyroidism, osteoporosis, long-term treatment of peptic ulcer with alkalizing preparations, excessive concentration of urine (e.g. when we drink little), overdose of vitamin D and incorrect diet also contribute to urolithiasis. of the resulting deposits, specialists say about oxalate, phosphate, urate and cystine stones. Treatment depends on the type, size and location of the stone.
Important- Percutaneous treatment, i.e. PCNL
It is most often used when the stone is located in the lower calyx of the kidney and there is no way for it to escape through the urinary tract. The procedure is performed in a hospital under anesthesia. The patient is lying on his stomach. The doctor, under ultrasound supervision, inserts a special, long needle into the kidney. When it touches the stone, it puts another needle on it, a bit thicker and even thicker on it, etc. The latter has the diameter of the index finger. Through this needle, the doctor can pull a small stone out of the kidney. If it is larger - ESWL and PCNL methods are combined. First, the stone is crushed with a sound wave and then "sucked" out. So that the crumbs do not fall into the ureter, it is secured,by introducing a small balloon-cork. After the procedure, you need to stay in the hospital for 3-5 days. Usually, one percutaneous procedure is enough to get rid of the stones. In some cases, not the kidney is punctured, but the bladder, and small stones or fragments of a large broken stone are removed from it.
- Ureterorenoskopia, or URSL
This method usually removes small stones (or fragments of previously crushed large stones) from the ureter or bladder. URSL is performed in a hospital under local anesthesia. The patient lies on the operating table, the doctor introduces micro-tools through the urethra into the bladder or ureter, which allow him to grasp the stone with small forceps and pull it out. If the stone blocked in the ureter cannot be pulled out, sometimes the doctor pushes it back into the kidney and uses ESWL or PCNL. You usually have to stay in the hospital for 2-3 days after ureterorenoscopy.
- Lithotripsy, or ESWL
It is performed on an outpatient basis, under local anesthesia. It consists in breaking stones with the help of a sound wave. This method is intended mainly for the removal of stones located in the upper calyx of the kidney. Before the procedure, you need to perform ultrasound, urography, general urine tests and culture, and clotting factors. Contraindication to lithotripsy is, inter alia, any obstacle that will prevent the pieces of crushed stone from escaping (e.g. narrowing of the urethra in men due to prostate enlargement), blood clotting disorders, as well as significant obesity. The patient is placed on a special table and the doctor maneuvers him in such a way that the sound wave coming from the head of the apparatus is precisely directed at the stone. The procedure takes about 40-50 minutes. One lithotripsy is not always enough to crush a larger stone, then the procedure is repeated after a few weeks. Before that, however (after 7-10 days), a control photo of the abdominal cavity is taken to see if the stone has crumbled or not.
Painful attacks of renal colic
If the stones are small, they do not move and do not block the outflow of urine - you may not even know that you have them, because they usually do not cause any ailments. But sometimes there is a bout of renal colic? This happens when the stone moves and blocks the urinary tract. Then there is a very strong pain in the lumbar region, radiating to the groin and genitals. It is accompanied by nausea, vomiting, abdominal distension, and pressure on the bladder. Sometimes after an attack, the amount of white blood cells in the blood rises, and the urine contains more erythrocytes and leukocytes.(eg Pyralgin, No-Spa, Galospa), take a warm bath, lie down and drink plenty of water. If the colic does not subside, the temperature rises and you cannot urinate, it is better not to delay the visit to the doctor, because you may end up with kidney failure.
You must do itDiet helps too
- In oxalate stones - avoid sorrel, spinach, rhubarb, tomatoes, chocolate, milk.
- In phosphate urolithiasis - limit the diet of milk and its products (except butter), avoid legumes.
- In urolithiasis - avoid offal, meat stock, sardines, herring, legumes.
- In cystine urolithiasis - limit eggs and milk.
Research: ultrasound and urography
Any type of kidney stone can be detected with an ultrasound scan. Sometimes, however, the doctor orders the addition of the so-called urography, i.e. 3-4 X-rays of the abdominal cavity after intravenous administration of the contrast agent. For what? Well, to see if it is dealing with the so-called urolithiasis (you can see the stones in the photo) or non-shading. Further therapy depends on the result of urography. In the case of urolithiasis (so-called gout) it is usually enough to use a special diet and medications (eg Allopurinol) that can dissolve quite large stones. Treatment of such urolithiasis usually takes about 6-8 weeks, while in the case of urolithiasis, the matter is much more complicated. The stones cannot be dissolved and a surgical treatment must be applied. Fortunately, today in over 85 percent. In cases, minimally invasive techniques are used: lithotripsy (ESWL), percutaneous surgery (PCNL) and ureterorenoscopy (URSL). A classic operation, such as cutting a kidney or ureter and removing a stone, is very rarely performed. It is mainly performed when the stones are very large, have filled the upper and lower calyx of the kidney and cannot be broken, or when the stone has fallen into the ureter and blocked the outflow of urine from the kidney. However, doctors use laparoscopy more often - a device with a tiny basket is inserted through small incisions on the abdomen, into which the stones are collected and pulled out. However, removing stones doesn't mean they won't reappear. So in order to reduce this danger even a little, you need to follow a proper diet and try to drink at least 2 liters of fluids during the day.
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