Urolithiasis

Urolithiasis is a condition characterized by the formation of stones in the urinary system. Urolithiasis can lead to the formation of fine-grained or powdery sand, as well as large stones in the kidneys, bladder, and other parts of the urinary system. The disease most often affects patients aged 22 to 50 years. According to statistics, urolithiasis accounts for approximately 30% of hospitalizations in the urology department. Without proper treatment, urolithiasis causes chronic pyelitis and pyelonephritis.

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Causes of urolithiasis

Causes of urolithiasis

The formation of sand or stones in the urinary system is directly related to metabolic disorders. A genetic predisposition to the disease also plays a role.

Kidney or bladder stones can form due to poor diet or drinking water with a specific chemical composition, which is high in salts. A sedentary lifestyle, sedentary work, and a deficiency of vitamins A and B contribute to the development of urolithiasis. Stones often form as a secondary complication of gastrointestinal diseases.

Secondary stones are also important. They form when urine flow is obstructed. Salt crystals within the urine precipitate and harden due to their high concentration.

Types of stones by composition:

  • Urates
  • Oxalates
  • Phosphates
  • Struvite
Ryabov Maksim Aleksandrovich
Ryabov Maksim Aleksandrovich
Urologist, Urologic Oncologist, Ultrasound Specialist
Experience: 23 years
PhD
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Khromov Roman Aleksandrovich
Khromov Roman Aleksandrovich
Urologist
Experience: 22 years
PhD
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Kotov Sergey Vladislavovich
Kotov Sergey Vladislavovich
Deputy chief physician of K+31 for urology, chief urologist of K+31, urologist-andrologist, oncourologist, doctor of medical sciences, professor
Experience: 22 years
Doctor of Sciences, PhD, professor
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Sorokin Nikolay Ivanovich
Sorokin Nikolay Ivanovich
Head of the urology department, urologist, oncologist, oncosurgeon, doctor of medical sciences, professor
Experience: 24 years
Doctor of Sciences, PhD, professor
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Kamalov Armais Albertovich
Kamalov Armais Albertovich
Chief consultant in urology, urologist, doctor of medical sciences, professor
Experience: 42 years
Academician, professor, Doctor of Sciences, PhD
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Denshchikov Mikhail Borisovich
Denshchikov Mikhail Borisovich
Urologist
Experience: 26 years
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Andranovich Stanislav Valerievich
Andranovich Stanislav Valerievich
Urologist, ultrasound diagnostics doctor
Experience: 29 years
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Survillo Igor Igorevich
Survillo Igor Igorevich
Urologist
Experience: 13 years
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Tereshchenko Suren Alexandrovich
Tereshchenko Suren Alexandrovich
Doctor urologist-andrologist
Experience: 28 years
Doctor of Sciences, PhD
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Medvedev Alexander Alexeyevich
Medvedev Alexander Alexeyevich
Urologist
Experience: 31 year
PhD
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Dzhabrailov Jabrail Abdulazizovich
Dzhabrailov Jabrail Abdulazizovich
Urologist, andrologist
Experience: 25 years
PhD
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Pshikhachev Ahmed Mukhamedovich
Pshikhachev Ahmed Mukhamedovich
Urologist, Oncologist
Experience: 23 years
Doctor of Sciences, PhD
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Gomberg Mikhail Alexandrovich
Gomberg Mikhail Alexandrovich
Dermatovenereologist
Experience: 43 years
Doctor of Sciences, PhD, professor
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Navruzbekov Gamzat Abdulkadirovich
Navruzbekov Gamzat Abdulkadirovich
The urologist
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Valeev Danil Ravilovich
Valeev Danil Ravilovich
Urologist
Experience: 6 years
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Dzhalilov Dmitry Olegovich
Dzhalilov Dmitry Olegovich
Urologist
Experience: 17 years
PhD
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Alferov Anton Sergeevich
Alferov Anton Sergeevich
Leading urologist, andrologist
Experience: 16 years
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Gabaraev Alan Petrovich
Gabaraev Alan Petrovich
Urologist, andrologist
Experience: 13 years
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Meshkova (Borodaykina) Daria Yurievna
Meshkova (Borodaykina) Daria Yurievna
Urologist
Experience: 10 years
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Nemenov Alexander Alexandrovich
Nemenov Alexander Alexandrovich
Urologist, oncologist (oncourologist)
Experience: 7 years
PhD
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Kosova Inga Vladimirovna
Kosova Inga Vladimirovna
Urologist
Experience: 23 years
Doctor of Sciences, Docent
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Symptoms of urolithiasis

A classic symptom of urolithiasis is renal colic. It occurs when urine flow is obstructed. Pain may depend on the location, type, and size of the stone. Most often, the pain radiates to the lower back, although it can also be felt in the groin or genital area. Before pain develops, urolithiasis usually presents with no specific symptoms.

In addition to severe pain, the patient exhibits signs of intoxication:

In addition to severe pain, the patient exhibits signs of intoxication:

  • Nausea and vomiting
  • Frequent urination
  • Blood in the urine
  • Pain during urination

If the stone is smaller in diameter than the ureter, it may pass on its own. However, in most cases, urgent medical attention is required. After collecting the patient's medical history, the urologist refers the patient for laboratory tests and diagnostic imaging:

  • Blood and urine tests
  • Ultrasound
  • Urography (X-ray)

An elevated body temperature may indicate that the patient is developing inflammation due to obstructed urine flow.

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Urolithiasis Treatment Methods

Emergency care for the patient involves relieving an attack of renal colic. Medication therapy is used, including painkillers and vasodilators. Next, the stone is removed, the inflammation is treated, and preventive measures are taken to reduce the risk of recurrence.

Conservative treatment for renal colic involves the use of medications (antispasmodics, diuretics), as well as fluid intake and a special diet. If inflammation is present, antibacterial therapy is administered. This treatment is effective if the stones are no larger than 3–5 cm.

Methods for treating urolithiasis

Surgical treatment is aimed at removing stones larger than 6 mm in diameter. The following techniques are used:

  • Extracorporeal shock wave lithotripsy — using a sonic shock wave to crush stones into smaller pieces that can pass through the ureter.
  • Contact lithotripsy — using an ultrasonic instrument, the optimal solution for high-density stones.
  • Percutaneous nephrolithotripsy — a puncture in the lumbar region through which a surgical instrument is inserted to break up the stone for subsequent removal — is used for large stones, more than 1–2 cm in diameter.

Important! In the presence of purulent inflammation, crushing and removing the stone using the methods described above is impossible. Full-scale surgical intervention is required.

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