What are the symptoms when a stone passes?

Urolithiasis is a disease manifested by the formation and presence of stones in the kidneys and other parts of the urinary system (ureters, bladder, and less commonly the urethra). Stones can be single, sometimes several or even many stones are formed – they consist of insoluble salts of different chemical composition (phosphates, urates, oxalates), but in 70% of cases they have a mixed chemical structure. The size of the stones can vary: from 1 mm to more than 10 cm in diameter. In some patients, the stones do not increase in size for a long time, in others, in six months they can fill, for example, the entire renal pelvis. Often stones form again, and then a relapse of the disease occurs. Urolithiasis is one of the most common urological diseases, affecting from 1 to 3% of the population in various regions of the world. The prevalence of urolithiasis depends on the composition of water, climatic, environmental, ethnic, dietary and other characteristics of a given region and its population. St. Petersburg and the Leningrad region belong to zones with a moderate to high prevalence of urolithiasis. It occurs in children and adults and often manifests itself not only in old age, but also in the most active period of life. In addition to congenital predisposition, the occurrence of urolithiasis is caused by a whole complex of various factors: dietary habits, water composition, harmful working conditions, sedentary lifestyle, lack of vitamin A and B vitamins in food, enzyme deficiency leading to metabolic disorders, parathyroid diseases glands, gastrointestinal tract, use of certain medications. Also, stones can form due to disturbances in the outflow of urine from the kidneys and bladder (developmental anomalies, functional disorders, narrowing of various parts of the ureter, prostate adenoma, urethral stricture), infections of the urinary tract and the presence of foreign bodies in it (usually sutures and other materials remaining after surgical interventions).

Symptoms of urolithiasis

The most characteristic symptom of urolithiasis is renal colic – a sudden attack of severe pain in the lower back. Changing body position has no effect on the intensity of pain. Often the pain is accompanied by nausea, vomiting, frequent urge to urinate and cramps. This acute condition is caused by a violation of the outflow of urine through the urinary tract and can occur after intense physical activity or ingestion of a large amount of liquid, when the stone begins to move and enters narrow places in the urinary tract (neck of the renal calyx, ureteropelvic segment, ureter and its narrowing in the area iliac vessels and outlet to the bladder). When the stone is in the lower parts of the ureter, pain occurs not only in the lumbar region, but also in the lower abdomen, radiating to the groin area and external genitalia. If the size of the stone does not exceed 5-6 mm (the diameter of the ureter), then, as a rule, it passes away along with the urine. If the stone is large and remains in the urinary tract for a long time, without moving and disrupting the outflow of urine, then the intervention of a urologist is necessary. Otherwise, atrophic (hydronephrosis) and inflammatory (abscess, carbuncle) processes may occur in the kidney, which can lead to loss of its functions, the development of a life-threatening septic condition, and even the need to remove the kidney.

Diagnostics

• Imaging – X-ray, ultrasound, CT, MRI
• Instrumental – urethrocystoscopy, ureteroscopy
• Laboratory research

The MEDSI St. Petersburg clinic has everything necessary for an accurate diagnosis: ultrasound examination of the kidneys and urinary tract, all types of necessary X-ray examinations and, if indicated, computed tomography and magnetic resonance imaging are performed here. These methods allow you to accurately determine the location and size of the stone, the condition of the urinary tract (renal cavity system, ureter and bladder, urethra) and urine outflow, prospects for spontaneous passage or the need to remove the stone. Our own laboratory provides the necessary results of blood and urine tests, which allow us to assess the presence and danger of a urinary tract infection to the body within a matter of minutes or hours.

Prices for treatment of urolithiasis at MEDSI

• Consultation with a specialist – RUR 2
• CT scan of the urinary system (kidneys, ureters, bladder) – 3 p
• Internal optical urethrotomy (hospitalization 1 day) – 42 p
• Urethral endoprosthesis (hospitalization 1 day) – 42 p
• Contact lithotripsy (hospitalization 1 day) – 43 p
• Percutaneous nephrolithotripsy – crushing and removal of large kidney stones (hospitalization up to 3 days) – 69 p
• Percutaneous mininephrolithotripsy is a minimally invasive method of crushing kidney stones up to 2 cm of any density (hospitalization for 2 days) – 58 p
• Urethroscopy and endoureterotomy (hospitalization 1 day) – 54 p
• Laparoscopic ureteroplasty (hospitalization up to 3 days) – 89 p

*The cost of surgical interventions includes: surgery, anesthesia and hospital stay.

Treatment of urolithiasis

Treatment of urolithiasis at the MEDSI St. Petersburg clinic aims not only to remove stones from the urinary system, but also to prevent its re-formation. Most stones (up to 70-80%) measure up to 0,5 – 1,0 cm and pass away on their own. This is helped by conservative treatment carried out under the supervision of a doctor. In most cases, we recommend a significant increase in fluid intake. Painkillers (analgesics), drugs that relax the smooth muscles of the ureter and bladder (antispasmodics), antibacterial and anti-inflammatory drugs are widely used.

If there is a situation that threatens the condition of the kidney (impaired urine flow, risk of purulent inflammation) or the stone does not pass on its own for a long time, urgent intervention by a urologist is necessary. To restore the outflow of urine from the kidney, it can be drained with a ureteral catheter-stent, which remains in the urinary system until the stone or its fragments are completely removed and then removed. In some cases, the kidney has to be urgently drained by puncture directly in the lumbar region under ultrasound guidance.

To destroy urinary stones up to 1,0 cm in size, the technique of external shock wave lithotripsy (ESWL) has been widely used for more than 25 years, when kidney and ureteral stones are destroyed using focused shock waves generated by a source outside the patient’s body and directed at him using X-ray or ultrasound guidance Despite the apparent simplicity and ease of the method, many shortcomings have been identified over many years of its use. The use of ESWL is possible only for relatively small stones, since the passage of a large number of fragments of large stones is often difficult and causes complications. Shock wave effects on the kidney in many patients over time cause the development of hypertension and deterioration of kidney function. In this regard, in recent years, video-endoscopic interventions have become the most preferred methods for removing stones from the urinary system, when an optical instrument (ureteroscope or nephroscope) is directly applied to the stone through the ureter (ureteroscopy) or by puncture in the lumbar region (percutaneous nephroscopy) under anesthesia and completely painlessly ), with the help of which the stone is removed entirely or destroyed and its fragments are also removed. Using these methods, stones of almost any size, including staghorn, are removed from the urinary system, without a high risk for kidney function.

At the MEDSI St. Petersburg clinic, along with providing all types of emergency care for renal colic, ureteroscopy operations are actively performed – removal and destruction of ureteral and kidney stones using a special instrument – a ureteroscope. A lot of positive experience has been accumulated. In approximately 15% of cases, when the stones consist only of uric acid salts (urates), they can be dissolved with the help of medications without surgery. But the treatment of urolithiasis does not end with the removal of the stone, since the conditions remain in the body for its re-formation. To prevent this from happening, the following is necessary:

• Correction of disturbances in the outflow of urine from the kidneys and bladder depending on their cause
• Analysis of the mineral composition of the stone in order to determine the optimal diet, drinking regimen and medications for the specific prevention of its re-formation
• Biochemical tests of blood and urine, hormonal studies to study various specific metabolic disorders in the body and their correction

After receiving the results of these studies, patients are given specific recommendations (urolithiasis metaphylaxis program). Doctors at the MEDSI St. Petersburg clinic carefully monitor the patient and monitor the implementation and effectiveness of the prescriptions made. Thus, at the MEDSI St. Petersburg clinic it is possible not only to get rid of stones, but also to put urolithiasis under complete control!

You can make an appointment online or call +7 (812) 748 38 95.

Bladder stones are the result of a systemic disease that develops as a result of metabolic disorders and/or the influence of unfavorable environmental factors.

This disease is treated by:

About the disease

Stones that are found in the bladder usually form in the kidneys. Then, under certain conditions, they migrate down the ureter. Stagnation of urine creates conditions for additional deposition of salt crystals on the stone that has entered the bladder. For this reason, it may increase in size over time.

Urolithiasis is a metabolic disorder. Risk factors have been identified that increase the likelihood of stone formation in the urinary tract. This:

• decreased physical activity;
• insufficient consumption of foods rich in vitamins A, B, D;
• taking certain medications;
• prolonged immobility due to illness;
• hard drinking water with a high salt content;
• chronic diseases of the genitourinary (chronic pyelonephritis, prostate adenoma) and digestive (gastritis, colitis, gastric ulcer) systems;
• hyperparathyroidism;
• abuse of foods that change the acidity of urine (spicy, sour, salty);
• untimely emptying of the bladder.

Types

Bladder stones are divided into 2 types based on size:

• small – up to 2-3 mm in diameter;
• large – can reach 15 cm.

In most cases, the chemical composition of stones is mixed. However, a certain substance is dominant. Based on this, the following varieties are distinguished:

• oxalate – oxalic acid predominates (they have a dense structure with spikes, which often injure the mucous membrane of the urinary tract);
• urate – uric acid (smooth surface, have a favorable course);
• phosphate – salts of phosphoric acid (have a smooth or rough surface, but low density);
• cystine and xanthine are rare.

Symptoms of the presence of stones in the bladder

Bladder stones can cause the following conditions:

• pain in the lower abdomen;
• pain and discomfort when urinating;
• change in the nature of the urine stream – intermittent, thin without pressure;
• frequent urination (less frequent decrease);
• red color of urine due to red blood cells.

If a stone blocks the internal urethral opening at the neck of the bladder, acute urinary retention may occur.

Causes of bladder stones

The causes of stone formation can be divided into the following groups:

• metabolic – caused by changes in pH and chemical properties of urine;
• infectious – associated with chronic infections of the urinary system;
• genetically determined – have a hereditary predisposition and are associated with defects in enzyme systems in the renal tubules;
• caused by taking certain medications – vitamin-mineral complexes, sulfonamides, etc. can lead to stone formation;
• idiopathic – after a thorough examination, the cause of the formation of stones cannot be determined.

Today, the main factor in stone formation is considered to be metabolic disorders, which affect the water-electrolyte and chemical composition of the blood. The effect of these factors is especially significant against the background of burdened heredity.

Get a consultation

If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.

You can find out more about the disease, prices for treatment and make an appointment with a specialist by calling:

Why SM-Clinic?

Treatment is carried out in accordance with clinical guidelines
Comprehensive assessment of the nature of the disease and treatment prognosis
Modern diagnostic equipment and our own laboratory
High level of service and balanced pricing policy

Diagnostics

The following imaging techniques may be used to detect bladder stones:

• ultrasound scanning (ultrasound);
• radiography, incl. excretory urography, which involves the introduction of contrast;
• CT scan;
• Magnetic resonance imaging;
• diagnostic cystoscopy – insertion of an endoscope into the bladder cavity.

As part of a comprehensive examination and determination of the nature of stone formation, a general clinical blood and urine test, a biochemical blood test, and hormonal screening are performed.

Expert Opinion

When calculi are detected in the bladder, it is important to establish the nature of their origin. To do this, the doctor prescribes an extensive examination, based on the results of which a treatment program is drawn up. You should not delay your visit to the urologist, because. small stones can be removed from the body with medication, and some can be treated with non-invasive endoscopic treatment.

Urologist-andrologist of the highest category

Treatment

Bladder stones have different chemical compositions. Some of them can be dissolved with the help of medications and a special diet, others are stable and require radical removal.

Conservative treatment

Urate stones in the bladder of men or women are the only type of stones that can be lysed and eliminated non-surgically. The doctor will create a diet and recommend taking medications that will lead to alkalization of urine, which will promote dissolution.

Stones of any chemical structure that have a diameter of less than 4 mm can pass out of the body on their own. To do this, it is recommended to drink at least 2,5-3 liters of fluid, adhere to a diet, and take antispasmodics when the stone begins to pass. The passage of a stone is a rather painful process that can take 3-4 weeks.

Surgery

The operation is performed for large stones. In modern urology, preference is given to minimally invasive endoscopic interventions. The cystoscope is inserted into the bladder through the urethra (transurethral access). Under visual control, the doctor grabs the stone, crushes it and removes it in fragments.

If endoscopic surgery cannot be performed, cystolithotomy is performed. The surgeon opens the anterior abdominal wall in the suprapubic region and removes all stones intact. The surgical wound is sutured in layers and covered with a sterile bandage.

For small stones, non-contact cystolithotripsy can be used. This is the crushing of stones using electromagnetic shock waves.