Kidney stones are a fairly common problem. Such structures can have different sizes, shapes and compositions. This pathology is quite dangerous, because neoplasms often block the urinary tract, preventing the removal of fluid from the body. It is in such cases that crushing of stones in the ureter is necessary.
Of course, faced with the need for such a procedure, patients seek any additional information. So how does the crushing of stones in the ureter occur? What methods does modern medicine offer? Are there any contraindications to such a procedure? How long is the rehabilitation period? The answers to these questions will be useful to many.
Kidney stones: symptoms
Urolithiasis is a fairly common disease, which is accompanied by the formation of hard stones of various shapes and sizes. The composition of the stones may also differ - the formations containurates, oxalates, phosphates, calcium s alts.
Stones tend to increase in size and move along the urinary tract, injuring tissues. Large stones can lead to deformation of the kidney, as well as partially or completely block the ureter, which provokes the development of renal colic.
Such a pathology is accompanied by very characteristic symptoms. Patients complain of sharp and sharp pains in the lumbar region, in the lower abdomen. Sometimes soreness extends to the external genital organs (scrotum, vulva). Symptoms of renal colic include weakness, severe nausea, fever. There is a sharp pain during urination. Urine becomes cloudy, sometimes contains small grains of sand and blood. With blockage of the urinary tract, false urges to empty the bladder may appear, a sharp decrease in the daily amount of urine.
In such cases, you can not hesitate - you need to see a doctor as soon as possible.
Methods for removing stones
Modern medicine offers several methods of treating pathologies associated with the formation of kidney stones:
- Therapeutic treatment - carried out with the help of special preparations and decoctions of medicinal herbs. This technique is effective only if the formed stones are small.
- Removal of large stones is carried out by lithotripsy. This is a minimally invasive technique, which consists in crushing the formed stones, the particles of which are then excreted from the body naturally. The destruction of stones can be carried out using a laser beam or ultrasonic waves.
- Surgical removal is rare. The procedure is effective in case of formation of large stones.
Doctors choose the appropriate method of treatment based on the age of the patient, the size and composition of stones, the presence of concomitant diseases.
Conservative treatments
Drugs and medicinal herbs are selected depending on the composition of the stones. For example, in the formation of urate calculi, agents such as Cystenal, Uranil and Blemaren are effective. Decoctions of dill seeds, parsley fruits, birch leaves, horsetail grass will be useful. Sometimes, against the background of such therapy, a sharp increase in the level of uric acid in the blood is observed. In such cases, patients are additionally prescribed benzobromarone or allopurinol.
In the presence of stones formed from calcium and phosphate s alts, drugs such as Fitolizin and Canephron are used. As for medicinal herbs, some doctors recommend taking decoctions of burdock, madder, calamus, parsley, bearberry, lingonberry.
If the stones consist of oxalates, then the reception of Cyston and Fitolizin will be effective. Decoctions of knotweed, corn stigmas, dill, baked mint help to cope with the problem.
The task of conservative therapy is to dissolve stones. It is impossible to use decoctions of herbs and medicines on your own - first you need to diagnose and determine the composition of the stones. Unfortunately, it is far from always possible to cope with the disease using medications. In such cases, the doctor decides whether to crush or remove the stones.
Diagnostic measures
Ureteral stone crushing is a safe procedure, but it is not effective in every case. Diagnostics is extremely important, which makes it possible to check the patient for contraindications.
- Analysis of urine and blood (including sugar) helps to determine the presence of inflammatory processes and diseases of the endocrine system.
- Fluorography is also carried out, since such a procedure is contraindicated in active forms of tuberculosis.
- Additionally, it is recommended to donate blood for biochemical analysis - a coagulogram and liver tests are performed.
- Mandatory is an ultrasound of the kidneys, ureters and other organs of the small pelvis. This procedure makes it possible to determine the shape and size of stones, their exact location.
- Urography is also needed.
- A patient donates blood to test for HIV infection and syphilis.
- If there are problems with the cardiovascular system, a consultation with a therapist and electrocardiography is indicated.
How to prepare for the procedure?
Crushing stones is a manipulation that requires some preparation. Gases in the intestines can interfere with the procedure, so a few days before the operation, the patientyou need to follow a special diet. From the diet it is necessary to exclude lactic acid products, legumes, fatty foods, juices, black bread, fresh vegetables and fruits, in a word, everything that enhances the processes of gas formation in the intestines.
Immediately before the procedure, the patient is given an enema, as the intestines must be freed from the accumulated feces and gases in it.
Ultrasonic crushing of stones in the ureter
This procedure is by far the most affordable and effective. Crushing stones in the ureter by ultrasound is a safe technique. The endoscope and ultrasound device is inserted directly into the renal pelvis through small punctures in the skin. Under the influence of ultrasonic waves, stones are destroyed, forming fine sand.
Crushing stones in the ureter with ultrasound allows not only to get rid of solid formations, but also to clean the walls of the canals from s alt deposits, thereby preventing the growth of new stones.
Removal of stones with a laser
Laser crushing of stones in the ureter is another effective and safe procedure. During the operation, an endoscope is inserted into the renal pelvis, which allows the specialist to get a good overview of the stones. With the help of a laser, the doctor destroys solid formations - they break up into small parts. To date, there are devices that allow you to destroy even the smallest grains of sand.
Crushingstones in the ureter with a laser does not take much time and does not require general anesthesia - only light sedatives are administered to the patient. The punctures in the skin are very small and there is no direct contact with the patient's blood, minimizing the possibility of tissue infection. The laser acts directly on the calculus without injuring the tissues of the excretory system. After the procedure, the patient's condition is observed for several hours, after which he can go home. Rehabilitation does not require much time - a person can return to their usual way of life almost immediately.
External lithotripsy: features and disadvantages of the procedure
This technique consists in exposure to air waves, but not through punctures of the abdominal wall or urethra, but directly through the skin. This procedure is rarely used. The fact is that the vibrations crushing the stones are so strong that they can injure the tissues of the kidney and even cause its contusion, which is fraught with dangerous consequences, even death.
There is another kind of procedure - the equipment is inserted into the urinary canal through the urethra, after which they act on the stones with air and mechanical waves. The operation is not performed if the stone is too large and hard or located directly in the kidney.
Contraindications for lithopripsy
Crushing stones in the ureter is not always possible. Regardless of the type, such procedures have a number of contraindications, the list of which is as follows:
- stonescoral-shaped;
- pregnancy;
- various bleeding disorders;
- the patient has a pacemaker;
- abdominal aortic aneurysm;
- presence of large cysts in the kidneys;
- acute infectious diseases, such as a cold or SARS (in this case, you first need to undergo a course of treatment);
- pathological changes in bones;
- oncological diseases.
Non-contact crushing of stones in the ureter: reviews. What happens after the procedure?
Removal of stones with laser or ultrasound is a minimally invasive procedure. However, after crushing a stone in the ureter, some deterioration is possible.
Patients complain of frequent urination, which is accompanied by cramps and pain, which is associated with the passage of remnants of calculi through the urinary tract. Small stones can damage the tissues of the urethra, which is accompanied by the appearance of blood impurities in the urine. It is possible to increase body temperature to subfebrile values (37-37.5 degrees). Sometimes there are back pain and signs of renal colic, which can be easily removed with antispasmodics. Feedback from patients and doctors indicates that these symptoms go away on their own after a few days.
After the procedure, the patient needs rest, bed rest and proper diet. In addition, patients are prescribed non-steroidal anti-inflammatory drugs (they prevent the development of the inflammatory process and relievepain), antibiotics (for the prevention of infectious diseases), antispasmodics and diuretic teas (accelerate the process of removing stones from the body).
Possible complications after non-contact crushing
In most cases, the crushing of stones in the ureter passes without any problems, because during the procedure, state-of-the-art equipment is used. However, therapy may be associated with some complications:
- Patients with chronic kidney disease (eg, pyelonephritis, glomerulonephritis) may experience exacerbation of the disease after the procedure.
- Sometimes hematomas appear in the tissues of the kidney.
- Sometimes after the procedure, a so-called residual path of calculi is formed. Fragments of stones are not completely removed from the body, but clog the duct, which leads to a relapse.
After the procedure, you need to carefully monitor your well-being - consult a doctor if there is any deterioration.
Surgical treatment
In fact, it is extremely rare for patients to have a full-fledged surgical operation. Crushing stones in the ureter, as a rule, helps to get rid of stones. The indication for surgical treatment is only the presence of large stones (their size exceeds 20-25 mm). This is an abdominal procedure that is performed under general anesthesia. Of course, after the operation, the patient needs long-term rehabilitation and special medication.
