Urolithiasis is the most common disease among the pathologies of the kidneys and organs of the urinary system.
This is an metabolic disease, during which, due to the crystallization of salts, stones are formed in the kidneys, ureters, and bladder. Of the 100 cases of diseases of the urinary system, 13 account for urolithiasis.
About 5.5% of the world's population suffers from this disease.
In men, urolithiasis is more common than in women - this is due to the anatomy of the male urogenital system.
In women, “coral” stones are more common — calculi of complex convoluted shape, which can spread and occupy the entire pyelocaliceal system, and then part of the kidney will have to be removed.
Kidney stones can be single and multiple (a unique case is known with the extraction of up to 5000 stones during surgery), from 1 mm to 10 cm or more, weighing up to one kilogram.
The disease affects people of any age - from 20 to 60 years. Urolithiasis can be either unilateral or bilateral (in 30%).
Urolithiasis in women - causes
The exact causes of urolithiasis in women are currently unknown. There are a number of suggested reasons.
1. Congenital kidney disease (polycystic, various developmental abnormalities) lead to stagnation of urine in them, resulting in a stone formation process.
2. Chronic inflammatory diseases of the kidneys of an infectious etiology (pyelonephritis, glomerulonephritis, less commonly cystitis): salt crystals “precipitate” on the protein molecules contained in the urine during these infections, and stones form later on.
3. Disruption of calcium metabolism resulting from bone fractures, diseases of the stomach, intestines, parathyroid glands, metabolic diseases (gout), a sedentary lifestyle.
4. Nutrition - eating a lot of meat.
5. Heredity.
6. Ecology of the environment.
A prerequisite for stone formation in the kidney is the content in the urine of an increased amount of salts and protein. The process itself lasts for months, and more often for years. This occurs against the background of chronic kidney disease, when a protein appears in the urine, and salts precipitate on its particles. Over time (months to years), stones of a few centimeters in size grow from particles of a few millimeters in size. Hereditary predisposition plays a large role. The initial stones a few millimeters in size are independently excreted in the urine. In the future, as they grow, stones can reach 10 centimeters, sometimes of gigantic dimensions, weighing several hundred grams. In the presence of such stones, the outflow of urine from the kidneys completely stops.
Urolithiasis in women - symptoms
Symptoms of urolithiasis in women are diverse:
symptomatology may be absent altogether or may occur with the development of extremely serious complications (with renal colic or kidney block).
Most often, at the initial stages of development, the main symptoms of urolithiasis in women are:
- Cramps and burning during urination and above the pubis - occur when the so-called "sand" comes out up to 2 - 3 mm in size;
- violation of urination: urination, a decrease in the amount of urine or urinary retention - this occurs when the kidneys block with calculi. If urine is absent for several hours (obstructive anuria), urgent need to seek medical help. Occurs infrequently: with bilateral stones in the ureters or in the case of a single kidney.
- intense pain in the lower back with shaking riding, a sharp change in body position, with heavy drinking of brines, beer - these pains arise due to a slight displacement of stones;
- a sharp increase in temperature is the result of an attached infection and an inflammatory reaction to the stone at the site of its contact with the mucosa;
- renal colic - a complication of urolithiasis, accompanied by intense acute pain in the lumbar region, difficult to stop, sometimes radiating to the leg, stomach, along the ureter;
- cloudy urine, sometimes with blood contained in it (mainly, with renal colic or when sand is moving away, sharp particles damage the mucous membrane of the ureters, as a result of which red blood cells enter the urine).
As already mentioned, the process can be either one-sided or affect both kidneys. The nature of the pain, its localization makes it possible to determine the affected kidney or ureter.
For the diagnosis of urolithiasis, in addition to biochemical and general clinical blood and urine tests, it is necessary:
- Ultrasound of the kidneys (but not all calculi are determined by ultrasound);
- survey urography (for general information about calculus: size, shape, localization, possibly density);
- excretory urography: with intravenous administration of contrast at the location of the calculus, changes in the form of a filling defect are determined.
Urolithiasis in women - treatment
Despite the various symptoms of urolithiasis in women and the different nature of the stones, there are general principles for the treatment of the treatment of this disease.
1. Drink plenty of water - up to two liters of fluid during the day. Such a volume of fluid dilutes the urine, reduces its concentration and prevents the formation of stones. Cowberry and cranberry juice are ideal in this regard.
2. Therapeutic nutrition - a properly selected diet, taking into account the composition of the stones, contributes to their crushing, dissolution and elimination.
3. Physical activity contributes to the rapid removal of stones.
4. Herbal medicine - herbs with anti-inflammatory, diuretics.
5. Treatment of inflammatory diseases in the kidneys.
6. Sanatorium treatment.
Surgical or conservative methods are used to treat urolithiasis in women, taking into account the stage (exacerbation or remission).
Treatment of urolithiasis in women during remission and still absent complications depends on the chemical composition of the calculus. Quite often there are stones of the following chemical composition:
- urates - uric acid stones;
- calcifications;
- phosphate stones.
1. If urate is detected, the following drugs are effective:
- leading to a decrease in the content of uric acid and contributing to its rapid elimination (Allopurinol, Allomaron, etc.);
- promoting alkalization of urine (Uralit, Magurlit, etc.);
- herbal medicines with anti-inflammatory and diuretic effects (Kanefron and medicinal herbs with the same mechanisms of action);
- enzymes - their action is to dissolve the organic part of the stone (Festal, Panzinorm, etc.).
Diet with urate stones should be limited to meat products, because urea is a product of protein metabolism.
2. Treatment of urolithiasis in women with calcium stones:
- drugs that accelerate the excretion of excess calcium from urine (Cyston, Xidifon, Blemaren);
- vitamins of groups B and D;
3. In the treatment of phosphate stones are used:
- preparations for the acidification of urine (methionine, ammonium chloride);
- drugs with antiphosphate action (Almagel).
These are the most intractable patients. A diet in the presence of phosphate stones should be aimed at acidifying urine, so you need to reduce the use of dairy products, vegetables, fruits, and limit the drinking regimen. Include eggs, oatmeal, boiled fish and meat in the diet. Acidic mineral waters contribute to the dissolution of phosphate stones (Truskavetskaya, Zheleznovodskaya).
In the presence of stones of any composition, a course of antibiotics is necessary (taking into account the bacterial seeding of urine), drugs that improve the microcirculation of the kidneys (Pentoxifylline, Trental, Agapurin, antiplatelet agents, Kanefron). In all cases, antispasmodics, analgesics, hot baths, a special diet are used.
The diet consists of drinking two liters of fluid per day, limiting sodium chloride, animal protein, foods high in calcium, oxalic acid and purine bases.
Surgical treatment is also used to remove stones - mainly, with the development of complications.
Lithotripsy is a method of destroying stones with ultrasound to small fragments; particles of stone are excreted independently with urine. This method is applicable only with stones of a certain density and composition.
Urolithiasis in women - prevention
Prevention of urolithiasis in women includes general provisions that will help to avoid the formation of stones of any composition.
1. Nutrition - eliminate or reduce salty, spicy, fried, fatty foods, strong tea, chocolate, cocoa, coffee.
2. A large amount of water - up to two liters per day in the absence of serious diseases of the cardiovascular system with the presence of edema.
3. Active lifestyle.
4. Avoid hypothermia.
For any urination disorders, urgently contact a urologist, since urolithiasis in women is dangerous, in addition to serious complications for the kidneys, also the development of infertility. In addition, urolithiasis in women refers to extremely serious diseases that can end fatally with improper treatment. Therefore, self-medication is unacceptable and dangerous. A narrow specialized specialist - a urologist is engaged in the treatment.
