If the stone came out why does it hurt. How kidney stones come out - symptoms and further treatment

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The kidneys are designed to filter liquid waste products and then remove them from the body as part of urine, i.e. urine. During these processes, individual chemical elements and their compounds contained in the urine settle on the inner surface of the kidneys, which causes the formation of the so-called kidney sand, i.e., small crystals. Gradually, calculi form from small particles, i.e. kidney stones. They are larger.

The diameter of the ureter in adult men does not exceed 0.8 cm, its length is no more than 40 cm. In women, these dimensions are slightly smaller. The passage of large stones is hampered not only by their size, but also by their irregular shape. Such neoplasms can have sharp protrusions, edges, etc. If they go along the ureter, they cause damage to its inner walls.

What is nephrolithiasis

In the early stages, nephrolithiasis is often asymptomatic. Small neoplasms are partially released as part of urine, i.e. urine.

The main problems in men or women with kidney stones begin when large stones pass through the ureter. When passing through, such neoplasms can damage the inner surface of the ureter. In addition, large stones cannot come out on their own and get stuck inside the ureter. This disrupts the process of urine excretion and causes severe pain. This situation requires serious treatment in a hospital setting. In some cases, it is necessary to carry out a surgical intervention.

Symptoms of the disease

Kidney stones discovered in the early stages of formation allow, with the help of the necessary treatment, to get rid of them without any special problems and prevent the process from continuing. Patients with diagnosed pyelonephritis should be especially attentive to their health; this disease is much more common in women.

The first signs indicating that kidney stones have begun to form are not taken into account at first. It should be remembered that kidney stone disease causes the following symptoms:

aching low back pain, aches; frequent urination; pain during emptying of the bladder; opacity of urine; blood particles in urine; change in the density and color of urine during urination.

When these signs appear, you need to see a doctor for a complete examination. After all, kidney stones can cause colic with severe pain, which increases even with the most ordinary movements, not to mention more or less strong loads. In a state of complete rest, the pain does not go away at all, but loses its intensity a little.

Another serious problem that kidney stones can provoke is self-poisoning of the patient's body. This happens when large stones become lodged in the urethra. Urine cannot pass out normally. The harmful substances contained in its composition enter the internal organs, causing various ailments.

Urolithiasis in children

Unfortunately, in recent years, children often suffer from urolithiasis. The main reasons for this:

heredity; intrauterine developmental defects; the consequences of the transferred infectious and inflammatory diseases; improper nutrition.

The first signs of stone formation in a child's body are dysfunction of the parathyroid glands or the digestive system. If they are found, it is imperative to examine the child for urolithiasis.

Treatment methods

Urolithiasis is treated only on the advice of a doctor. After all, renal calculi have a different composition. Treatment is prescribed only after its determination by laboratory methods. The patient is prescribed the intake of funds, under the influence of which the dissolution of the calculus begins. To help drug treatment, a diet is drawn up, which must be strictly observed. For the treatment of concomitant infectious and inflammatory diseases, the necessary antibiotics are prescribed.

At present, especially difficult cases of urolithiasis are treated with the help of open abdominal operations only with renal failure or a very large calculus size.

Removal of organs during such operations is extremely rare.

In case of blockage of the ureter with a large stone, a medical restoration of blood microcirculation and a course of treatment with drugs from the group of antibiotics and antioxidants are preliminarily carried out. Removal of urine accumulated in the kidney is carried out artificially using appropriate medical instruments.

How stones are excreted from the body

You can understand how kidney stones come out by the following symptoms:

severe pain syndrome; acute pain in the renal and lumbar region with a return to the thigh and groin area; renal colic; hyperthermia and chills; almost continuous urge to urinate; unbearable burning sensation; blood in the urine.

The exit of a kidney stone can last for a long time (from 7 to 30 days), while the calculus goes through the ureter. Without taking appropriate measures, a new calculus begins to form in the kidney. After the stone comes out, it is necessary to carry out a course of medical and preventive procedures in order to prevent a repetition of the process.

After the kidney stone has left, the symptoms gradually subside. Painful sensations stop after a while. Body temperature and general well-being are normalized. Urination occurs as usual.

Large stones cannot come out on their own, while forming plugs in the ureter. This kind of plug will certainly cause an additional attack of pain and colic. If at the same time it becomes impossible for the natural passage of urine through the ureter, the patient may develop hydronephrosis.

Treatment activities

After the detection of urolithiasis, the patient needs to be prepared for the fact that kidney stones may come out. What to do in this case, the doctor will tell you in detail. On his recommendation, you should purchase the necessary drugs in advance and store them in your home medicine cabinet. Among the necessary medications must be:

antispasmodics to expand the diameter of the ureter and relax its muscles; analgesics to reduce pain; herbs, the decoction of which has a diuretic power.

Analgesics can be taken by mouth. Antispasmodics are best administered by injection. Then take the necessary herbal decoction.

A hot bath will help speed up the process of leaving the stone from the ureter. You need to take it from 15 minutes to half an hour. In this case, it is necessary to drink plenty of fluids so that the stone goes out faster.

After taking a bath, it is necessary to do special gymnastic exercises, previously agreed with the doctor. This can be brisk stair climbing, squats, etc.

It is better to urinate in a suitable container so as not to miss the stone that has come out. Urine mixed with blood will indicate damage to the walls of the ureter by the sharp edges of the exiting calculus.

The stone will need to be shown to the doctor, who will prescribe the necessary laboratory tests to determine the composition of the calculus and some other necessary information. The patient must undergo an ultrasound examination. All the data obtained will be used in the appointment of subsequent treatment.

After the self-excretion of the kidney stone, the patient undergoes a course of drug therapy and supportive treatment at the appropriate resort. In the presence of an infection, an antibacterial course is carried out until it is completely cured.

At the same time, adherence to a lifestyle and an appropriate diet is important. The diet is compiled by a dietitian on the recommendation of the attending urologist.

Special diet

Depending on the nature of the stones, an individual diet is drawn up, which must be strictly adhered to. With urate neoplasms, it is necessary to exclude or significantly limit the consumption of fatty meat and fish, smoked meats, fried foods. In this case, lentils, mushrooms, nuts, legumes have a negative effect on the body. The use of alcoholic beverages is categorically unacceptable.

If calculi have a calcium-oxalate composition, in addition to the above products, you should also refuse cocoa, chocolate, coffee, some vegetables and fruits, and fermented milk products.

Concrements of a phosphate nature require limiting the use of vegetables, fruits, dairy products. To prevent kidney stones and facilitate the elimination of existing stones, it is necessary to increase the amount of fluid consumed. An adult patient may need up to 2 liters of fluid daily. Cranberry and citrus juices (orange and lemon) are especially useful.

The main principle of drawing up a diet for patients with urolithiasis is to increase the magnesium content while reducing the amount of sodium in the foods consumed. Therefore, it is necessary to include in the diet such foods as seafood, sprouted wheat grains, vegetables with dark green leaves.

The presence of calculi in the kidneys is a fairly common phenomenon that affects people of different ages and sexes. The quality of nutrition, the characteristics of the body's metabolism, genetic predisposition - all this affects the likelihood of the formation of a foreign element in an important organ. Despite the fact that sometimes the presence of such a neoplasm comes as a surprise, each patient needs to know what to do if a kidney stone is coming. This will make it easier to feel and contribute to the removal of calculus outside, eliminating the need for surgery.

Signs that a stone is moving out of the kidney

During urination, only small stones can come out of the urethra on their own, therefore, considering the likelihood of eliminating calculus without the use of aids, this fact should always be taken into account. There are certain symptoms that characterize renal colic and the advancement of a stone into the ureter.

Pain syndrome. An acute unpleasant sensation can have a shingles in nature, spread not only to the lower back, but also to the sacrum.

Burning sensation - when it reaches its peak and becomes extremely intense, the patient may even lose consciousness. Raising the level of blood pressure to high numbers. Hypertension is caused by mechanical action on the renal artery. More often, this phenomenon occurs in cases where the stone is stuck in the ureter and does not come out. Dyspeptic disorders. Deterioration in patients' well-being often passes the stage of nausea, developing into prolonged urge to vomit.
An increase in the general body temperature to subfebrile numbers.
Chills (precedes hyperthermia and does not always accompany it).
The presence of blood in the urine is caused by damage to the walls of the ureter by the sharp edges of calculi.
Swelling of the limbs and face.
Neurological disorders - the patient is restless, he is disoriented in time and space, extremely irritated, restless.

When the neoplasm moves from the renal pelvis, the listed manifestations occur in a complex. The degree of their intensity in different people is individual, but the connecting factor is the need for first aid.

Patients often associate an attack of renal colic with labor, largely due to a combination of muscle tension and intense pain. However, the way kidney stones come out in women may indicate other pathological processes, since the symptoms resemble the course of appendicitis, cholecystitis, pancreatitis, ectopic pregnancy, colitis. It is important to carry out a timely differential diagnosis.

First aid when moving stones

The extent to which help will be provided in the exit of kidney stones sometimes predetermines the need for surgical intervention: you need to act competently and without delay. First of all, you need to call an ambulance, and before she arrives, take a comfortable position. It is difficult to adhere to bed rest when the pain is so severe, but a sitting position in which the patient tilts the torso forward is beneficial.

You can fill the tub with hot water and lie down for at least 20 minutes, constantly refilling the tank as it cools. High temperature water will distract the patient's condition, and will also relax the tense walls of the ureter: when exercising physical activity, it will be possible to move the stone closer to the exit from the urethra. For the same purpose, a heating pad is used by placing it on the area of ​​the bladder and lower back.

Attention! It is strictly forbidden to be in hot water with an increase in blood pressure! People with concomitant diseases of the heart and blood vessels need to fill the bath to such a level that the water does not reach the chest area. It is also contraindicated to carry out this water procedure at the stage when urolithiasis was complicated by pyelonephritis.

The main task is to stop the pain syndrome. The pain that accompanies renal colic is one of the most excruciating sensations, so the primary goal is to make you feel better. However, this is not the only task that first aid for kidney stones pursues. It is equally important to prevent inflammation: the calculus moves, injures the mucous membrane, provokes the development of the pathological process, which means complications.

The following drugs will help to avoid this:

1. Baralgin. Anesthetic drug. Introduced intramuscularly. If the patient's condition is regarded as moderate, the drug is administered intravenously. In addition, it will provide a reduction in overall body temperature and high blood pressure levels.

2. No-shpa. Antispasmodic. Allows you to relax tense muscles, which will allow the stone to freely leave the renal pelvis, moving outward along the ureter. Administered by injection, at the peak of a pain attack.

3. Papaverine. More often it is injected simultaneously with no-shpa (to create a more powerful antispasmodic effect), less often it is injected separately.

4. Ketans. Anesthetic drug is administered intramuscularly, provided that there is no allergy to the active ingredients.

5. Kanephron (capsules)- a preparation of exclusively natural origin. Its action is aimed at stopping the inflammatory process or preventing it. This is important when the stones stuck inside the ureter are displaced: especially when you consider how long a stone can leave the ureter (from 3-6 hours to several days). Blocking the lumen of the urinary canal, the calculus contributes to the development of the infectious process, which can turn into pyelonephritis, renal failure. Kanefron is allowed to be taken even by pregnant women: natural ingredients do not have a negative effect on the developing fetus.

It should be noted that it is permissible to administer or take analgesics before the arrival of the doctor only in cases where there is a clear understanding that the attack that has arisen is due to the advancement of the stone, and not appendicitis, colitis or ectopic pregnancy. Otherwise, it will be difficult for the doctor to establish the cause of the attack quickly, since the clinical manifestations will be distorted by taking an analgesic. The same applies to the heating of the lumbosacral zone: if there is any doubt about the origin of pain, it is better to wait for a doctor's examination.

In certain clinical cases, urologists perform the so-called water load, forcing diuresis: the patient is injected with a diuretic (Furosemide, Lasix) intramuscularly, then prescribed to drink 1.5 liters of purified water without gas and increase motor activity. A valid question - what are the consequences of this action? The stone, if it is small, will not only leave the cavity of the renal pelvis, but also be evacuated from the urinary tract as a whole, however, physical activity must be increased - more often the patient is asked to jump on one leg up the stairs - this stimulates the displacement and advancement of the calculus.

Important! When performing an accelerated diuresis, there will be frequent urges to urinate - this must be done in a previously prepared container so as not to miss the moment when the stone comes out. It will need to be shown to the doctor: after assessing the diameter, shape and features of the calculus, if necessary, the specialist will send the selected calculus to the laboratory.

Since the stone can block the lumen of the ureter, it is possible that urine flow will stop completely. This aggravates the general condition of the patient and requires urgent intervention. Acute urinary retention is a characteristic sign of how kidney stones pass out in men and women of different ages. Most often, this symptom is noted by patients with bilateral renal colic. Therefore, you need to release urine using a urethral catheter - otherwise, stagnating, it will cause an infectious process - pyelonephritis, or cause hydronephrosis. Urine evacuation is carried out by a doctor in a urological hospital.

The success of the action is determined by conducting an ultrasound scan. The specialist visualizes the position of the calculus, and also determines the chances of its independent discharge.

People who are diagnosed with nephrolithiasis should know how kidney stones pass. The fact is that the process of movement of calculi along the ureters and urinary tract can be very painful and even dangerous for the patient's health. Therefore, it is important to know what symptoms accompany the release of kidney stones, and what needs to be done to alleviate your condition.

Why are kidney stones dangerous?

The kidneys are an important organ system that filters all body fluids and excretes harmful substances in urine. In the process of purification, some chemical elements are deposited in the kidneys, and over time they turn into sand. When grains of sand accumulate under the influence of the acidic environment of urine, stones are formed, which can reach large sizes.

The main problem is that the stones are not in a stable position and sometimes begin to move along the urinary tract. The ureter is the narrowest point; in an adult man, its diameter is approximately 0.8 millimeters. This makes it difficult for kidney stones to escape, as many of them sometimes grow up to 1 centimeter in diameter.

Moreover, stones can have various shapes and sharp ends, which, when moving along the ureters, can touch its walls, causing pain to the patient. If the stone is too large, it simply gets stuck, blocking the flow of urine.

The process of leaving stones in most cases is accompanied by painful sensations. Sometimes the pain can be very severe and even unbearable. If the kidney stone is very large and has sharp corners, its movement can be very dangerous, because during its movement, damage to the walls of the urinary tract is formed, into which infection from urine can easily penetrate. This will inevitably lead to the development of an inflammatory process in the urinary tract.

Kidney stone symptoms

People who have kidney stones should be especially careful, because sometimes even small physical activity provokes the movement of stones along the urinary tract. However, the problem is that not everyone knows about the presence of the disease before the onset of painful sensations due to renal colic.

Most patients find out too late that they have kidney stones, when drug treatment can no longer help, and urgent measures must be taken to eliminate stones from the urinary tract.

There are some signs by which you can understand that there are stones in the kidneys:

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Frequent pain in the lumbar region with a pronounced aching character. Frequent urge to use the toilet. Painful sensations during the emptying of the bladder. Pronounced dark or yellow urine, not transparent. The appearance of blood particles in the urine. Changes in the characteristics of urine directly during urination. For example, a change in color or density.

These signs may indicate the presence of kidney pathology, therefore, if they are detected, it is necessary to contact a specialist to prescribe a full examination.

It is important to understand that calculi coming out of the kidneys can provoke severe pain, which will manifest itself with the slightest movements. In addition, when the urinary tract is clogged with kidney stones, there is a great danger that intoxication of the body will occur, or, in other words, self-poisoning. When urine does not leave the body, the toxic components contained in it begin to enter the internal organs, which leads to the appearance of various diseases and ailments.

Medicines for kidney stones;

How to treat kidney stones from 4 to 10 mm;

How to remove stones in the ureter at home.

Can urolithiasis appear in children?

Many parents are interested in whether a kidney stone disease can appear in a child, and what to do if the kid starts to get stones from the kidneys. It is worth noting that kidney stones in children nowadays are formed quite often. This happens for several reasons:

Bad heredity. Disorders in the development of the fetus during the period of being in the womb. Complications after infectious or inflammatory diseases. Wrong, unbalanced diet.

One of the first signs of kidney stones in a child is a dysfunction of the parathyroid glands, as well as problems in the digestive tract. These symptoms should be a signal for parents to take the child to a doctor for examination.

It is by no means possible to start the treatment of urolithiasis on your own, since you first need to go through a number of procedures to identify the size and quality of stones. Only after that will the specialist be able to select medicines to dissolve the stones or to prescribe an operation.

How to understand that stones have come out of the kidneys?

The passage of kidney stones is always accompanied by many symptoms. You can understand that the movement of calculi along the urinary tract has begun by the following signs:

severe pain; acute pain in the lumbar region and kidneys, which can radiate to the groin area and thighs; renal colic; increased body temperature, chills; constant urge to urinate; severe burning sensation; the appearance of blood in the urine.

The movement of a kidney stone along the ureter can take a long time. At least this process lasts a week, maximum - a month (depending on the size of the calculus). At the same time, a new stone will (most likely) form in the kidneys at this time, which will then also begin to move along the urinary tract. If, after the release of the kidney stone, the patient does not take any action regarding the solution of the problem and treatment, there is a high probability that the situation will repeat itself.

After the stone leaves the kidney and urinary tract, all unpleasant symptoms gradually disappear. The patient's severe pain disappears, the general condition of the body is normalized, the body temperature returns to normal and the normal process of urination is restored.

Large stones can become lodged in the ureters, stopping further movement and obstructing the flow of urine. This problem is solved only surgically and in a short time, otherwise, due to intoxication in the body, the development of many other diseases will begin.

What to do if a kidney stone comes out?

If the patient has already been diagnosed with kidney stones, the patient should be prepared for the stones to begin to come out. This happens, as a rule, unexpectedly, so it is better to prepare in advance. Only a doctor can tell in detail about what to do if stones begin to move along the urinary tract. The first step is to purchase a number of drugs that will alleviate the patient's condition:

Antispasmodics... These drugs are necessary to eliminate renal colic, relax the walls of the ureter and expand its diameter for easier and faster passage of the calculus. In this case, No-shpa, Papaverine or Drotaverin preparations are perfect. Analgesics... The funds of this group will ease the pain syndrome. You can use Ketonal or Baralgin products. In some cases, doctors prescribe stronger pain relievers. Herbs that have a diuretic effect... During the release of stones, decoctions from such herbs will speed up the process of movement of the calculus along the urinary tract.

First, it is recommended to take pain relievers, for example, oral administration. Then you can connect antispasmodics, however, it is better to put them in an injection so that the remedy works faster. Well, after taking the drugs, you can start drinking herbal decoction.

A warm bath can also help relieve spasm in the ureter. However, do not lie in the water for too long, the procedure should take no more than half an hour. In this case, it is advisable to drink more diuretic decoctions so that the stone moves faster along the paths.

After carrying out this procedure, a number of special exercises are allowed. As a rule, patients are advised to walk up the stairs or squat, as such physical activity accelerates the passage of stones from the urinary tract. However, it is better to first discuss a set of exercises with your doctor so as not to harm yourself.

During urination, it is recommended to collect urine in a special container. Thus, the patient will not miss the exit of the stone and will be able to see blood impurities in the urine, if any. This sign suggests that there is wall damage in the urinary tract. On this fact, it will be necessary to undertake treatment aimed at disinfecting and preventing the development of the inflammatory process.

The stone itself will definitely need to be shown to the doctor. The specialist will prescribe a laboratory study that will determine the qualitative composition of the calculus. The research results will be used for further treatment of the patient. After all, it is likely that there are other kidney stones.

After the release of the calculus, the patient is necessarily assigned an ultrasound examination to determine the internal state of the organs of the genitourinary system, as well as the detection of other stones.

In addition, the patient is required to be prescribed a course of therapy, as well as a number of procedures at the resort, which will bring health back to normal. If an infection has been brought in during the stone release, the doctor also prescribes antibiotic therapy. The patient is prescribed a specific diet and lifestyle that will prevent further formation of kidney stones.

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How to determine whether a stone comes from the kidneys - this question worries many who have suspicions of urolithiasis. It is often very difficult to tell if you have colic or a kidney stone symptom.

Since pain in the lumbar region can be caused by a lot of reasons, it is necessary to clearly know all the symptoms of kidney stones coming out in order to identify them and take the right action.

There are two options for the development of the event, in the first, the stone comes out by itself without causing any discomfort, if a person leads an active lifestyle and eats right.

In the second case, the stone has sharp edges and can cause unbearable pain when exiting.

In this article, you can learn about all the symptoms of kidney stones coming out, the details of the process itself and how to cope with pain without the help of medication.

Leaving kidney stones: causes and signs of the process

There are the following signs of stones coming out - at first the urine is thick, and then turns into light and liquid. If a yellowish or reddish sediment appears in the urine, then this indicates the presence of a kidney stone, and its exit will be accompanied by cramps and pain.

Kidney stones are a crystal-like solid mass. They consist of salts, which are included in small amounts in normal human urine.

Stones can vary in shape and size. They can be the smallest grains that pass imperceptibly into the urine, or they can be large formations with a diameter of up to 10 cm of complex shape, and then the exit of kidney stones is accompanied by intolerable pain.

A person usually does not know about his disease until the stones begin to move along the urinary tract and change their location. Even a small stone leaving the kidney can cause excruciating pain.

Getting out of kidney stones: what to do?

Take antispasmodics and pain relievers to reduce fever and pain. If the pain persists and you notice blood in your urine, call your doctor.

What can a doctor do?

The doctor must relieve the patient's pain and conduct the necessary examination. Sometimes, to carry out the appropriate analyzes, as well as to determine the composition of the stones, it is necessary to collect the released stones. He may recommend further treatment, including drug therapy and diet.

If the patient's stone has increased in size, does not come out, causes stagnation of urine and constant pain, causes urinary tract infections and bleeding, surgery will be needed. The methods of ultrasonic stone crushing are also used now.

Exit the stone through the ureter

The human urinary system consists of several organs, the narrowest of which is the ureter. When there is a calculus, a person experiences from his own experience how narrow the ureter is. The size of the ureter is approximately 8 mm in diameter and approximately 40 cm in length.

Accordingly, stones less than 8 mm can pass through the ureter painlessly for humans. When there is a calculus exceeding 8 mm in diameter, then, purely theoretically, due to the elasticity of the ureteral tissues, stones with a diameter of 1 cm can pass through the ureter.

However, the patient will feel pain and there is a high likelihood of bleeding from the urethra. It is worth considering that the pain can be of different intensity, since the stones are not only of different sizes, but also can have a different composition and surface.

If the stone is smooth, it will not damage the walls of the ureter, but if the stone has sharp edges, then this most often leads to tissue damage, as a result of which blood is excreted in the urine.

How kidney stones come out. Measures to reduce discomfort.

1. When there is a calculus, a person experiences excruciating sensations. You need to take a pain reliever. The tablets may not reduce the intensity of the pain, then it is better to give an injection. In addition, the injection will not only have an effective effect against pain and relieve symptoms, but also expand the diameter of the ureter, and help relax its muscles. When there is a calculus, enlarging the diameter of the ureter is the best solution.
2. Go to the bathroom with hot water, and stay there for about half an hour. A hot bath can help reduce pain when calculus is present. However, it is worth remembering that in the presence of diseases like pyelonephritis, you cannot take a hot bath. If you take a bath for inflammatory diseases, then hot water can only accelerate the intensity of inflammation.
3. After taking a bath, you need to start actively moving around so that the stone does not stagnate. But, you should be prepared for the fact that with physical activity, pain symptoms are likely to arise, since it will not be possible to expel the calculus painlessly.
4. You need to drink plenty of fluids. When there is a stone, it is better to drink diuretic herbs.
5. Before each urge to urinate, especially when the calculus has gone, you need to prepare some kind of vessel in order to substitute it for the stone. This is necessary in order to hand over the calculus to the laboratory to recognize its composition.

As mentioned above, people may not know for a long time that they have stones in the kidneys or in the bladder cavity. Often the stones do not show signs until they are displaced. Many people are in a state of confusion when stones come out and do not know what to do in this case.

The answer is simple: you need to see a doctor and do an ultrasound scan to make sure that the calculus has come out completely and no part of it remains in the organ. Do not rely on the case when you managed to expel one calculus on your own. Treatment is necessary in any case, even if the pain is completely gone, since there may be several stones in the kidneys and in the bladder cavity.

If there are kidney stones: conservative treatment

These measures are considered effective only when stones are small in size, today there are drugs for dissolving stones, but they can only be taken as prescribed by a doctor.

Diet is considered an important part of the treatment process. Depending on the type of kidney stone, it is necessary to exclude certain foods from the diet. Dieting is also a preventive measure that aims to prevent the formation of new stones.

With urolithiasis, it is also necessary to drink more than 2 liters of liquid per day. Immediate treatment of the disease requires cases of the development of pyelonephritis and the addition of infection against the background of stones. Then you can't do without antibiotics.

Surgical treatment to get the kidney stone out

Surgical treatment is used when conservative treatment is ineffective. Previously, only open operations were carried out, which very often ended with the removal of the kidney.

Such operations are performed today only in case of severe disease and very large stones, which are accompanied by renal failure or purulent pyelonephritis. Before the operation, the patient undergoes mandatory preparation. He is prescribed funds to improve blood microcirculation, antibiotics and antioxidants.

If the urinary tract is completely closed with a stone, it is necessary to remove urine from the kidney, which can also be considered an operation. All these interventions lead to blood loss, complications and are performed under general anesthesia.

• If, as a result of some routine examination, a kidney stone is found in you, it may not be worth touching it at all, and you will live happily and for a long time with your "treasure", especially if the stone does not bother you. But if he went out? If the stone in the kidney is more than 10 mm, then it has little chance of moving away on its own, then it is necessary to either dissolve it or crush it. If the stone is less than 10 mm, it can come out on its own.
• So, the stone came out of the kidney, what to do - do not panic. In this case, it is better to insure yourself and, of course, consult a doctor, also be prepared for the fact that you may not have one stone. Many in this case resort to folk remedies. There are thousands of folk recipes and medicines for dissolving kidney stones. Although the official medicine refers to urolithiasis diseases that require surgical intervention. Often, such a strategy is justified, for example, with a large stone size, when an acute attack of renal colic occurs, when the stone can not independently pass for various reasons, and the patient then needs to be provided with surgical emergency assistance in order to save his kidney.
• If the stone in this case completely blocks the outflow of urine through the ureter, an acute attack of colic occurs, and if the lumen of the ureter is partially blocked, but the outflow of urine is still difficult, then hydronephrosis develops. In this case, the kidney can very quickly lose its function.
• The smaller the kidney stone, the easier and easier it is for him to go out with urine on his own. About nine out of ten kidney stones are less than 5 mm in size, and about five out of ten stones are 10 mm. Such stones are able to come out on their own. Only in 1 - 2 cases a special medical intervention is required.

Kidney stones are cleared on average within 1 to 3 weeks through the urinary tract, and two-thirds of the stones are cleared 4 weeks after the onset of symptoms.

If there are kidney stones, what to do?

If you know the chemical composition of the stones you have, then you can choose the appropriate treatment and diet based on it. But often kidney stones have a mixed composition, so monotonous diets in this case are harmful.

Nutrition for patients with urolithiasis should be complete. You should not fanatically exclude certain foods from your diet, you can only harm your body. It is worth forgetting about losing weight "by 10 kg for 1 wear" and other fashionable ways to ruin your health. Dramatic weight loss only leads to the prolapse of the kidneys and provokes a shift in the stone.

The experience of our readers - getting out of kidney stones

Remember, there was such a man in mythology who rolled stones up the mountain? He couldn't do anything. People with urolithiasis also roll stones. Only FROM yourself.
The process is rather unpleasant, but with the right approach, it is quite feasible.

So, when you strive to go out of small need, you have failed. the resulting drops clearly did not justify the costs of their production. A heaviness builds up to the left or right of the navel.
Congratulations! Most likely you have a kidney stone. And he wants to get out, one might say - wants to see the world. How can you help him by making the process faster and easier?

The best remedy for me is diclofenac. Soothes pain and relieves inflammation. If the stone went in the evening, having drunk diclofenac, you can admire the newborn microlite in the morning. It happened to me. Please note - there are contraindications.

Less radical remedies are urolesan and baralgin (revalgin). At the same time, you can drink herbs: mint, kidney tea, lingonberry leaf, St. John's wort. There are also contraindications, so we carefully read the instructions.

If the stone is delayed, an ultrasound scan should be done. Let's see its size, location, number of brothers. In 2007, I found seven pieces. The largest is 9 mm.

With the ultrasound, we go to the urologist. To the municipal one, you don't care. Get a piece of paper with a list of drugs and leave with faith in your strength. A paid urologist will show a little more attention (for your money) and send you for tests. Quite unexpectedly, the examination may show the presence of any other sores. We do not waste our time on trifles, but, if desired, we treat in a complex.

If the cobblestone is released for a long time, blood may leak out. pus and other fluids. Don't be scared. These are inflammatory processes. Tell urologists. Only the paid one will be interested. He will send him some more tests and prescribe antibiotics: nolicin or abactal. Side effects are also throaty. We accept it carefully.

If suddenly the process began to take months, you can take smooth muscle relaxants - omnik. Although the urologist will prescribe it so. Why is this? So that spasms do not interfere with the discharge of calculus. Unclear? Never mind, get sick with mine - you will know the terminology!

But finally! It is finished! I fell out. You can go to the ultrasound scan again to make sure that there is no other handsome man in the queue for the exit. Then you can drink cyston to prevent relapses.

If there is a stone, but it is firmly seated in its place, you can drink phytolysin - a mixture of various useful herbs. The tool dissolves and removes stones. The thing is gorgeous, but it doesn't help right away. And, as you may have guessed, there are contraindications.

Well, health to you! And everything, everything, everything! But not in the kidneys ...

Yesterday I got out of the hospital. The day before yesterday I arrived with my wife, I really died, I didn't know what was wrong with me.
The right side ached, and the pain increased gradually, slowly, but surely.

I woke up my wife at 10:00 (she is an owl), went to the hospital, since there is a car. How we drove and how I died in the hospital, not a story about that.

It took a long time to determine the diagnosis, a complete definition was given to me by a long-familiar pain-kabut on the tip of the blade tugging ... Stones, their mother ...

For those who are not in the know: The kidney has a structure of running into each other and frozen balls. When fluid leaves the kidney, the ureter has a thickness (total) 4 mm, then 180 mm to the bladder, in front of the bladder the thickness is about 7 mm, well, from bladder thickness not less than 10 mm.

So, stones are formed only at the exit from the kidney, i.e. directly in front of the ureter. The ureter has a structure far from the muscle, it cannot expand.
The greatest and unbearable pain is when the stone is torn off and the ureter passes, since the stone closes the passage of fluid and, under pressure, moves forward, tearing the ureteral canal along the way.

Well, or cutting, does not matter, the pain does not become less.

I directly foresee screams about sand .... Sand is formed constantly, in EVERY organism, the point is who is lucky when stones are formed. Whoever has never heard of them, and will never know, there are a lot of reasons.
So, the worst thing is when the stone finds a comfortable place in the ureter, in which the liquid is passed and it is not pushed by the liquid.

In the presence of an anesthetic, it seems that everything, everything has passed and there are no reasons for alarm, but. On the ultrasound, they tell you that the stone has risen, you need to jump, stomp and drink a lot of water, at least 5 liters a day, a day, not a day.

And the same thing happened to me. The pain went away, and okay, every second person will think. It was not there.
The stone is far from the first, at the first stone I stupidly jumped up the steps with a cotton swab dipped in ammonia on my face, I was lucky, I came out.

At the second exit, extraneous salts twisted at home, wait and lose time for an ambulance (I live in a village), I googled.

We mix the oil and juice, shake thoroughly, mix it, and, in one sip, inside.
The validity period is 3 hours. Well ... with the third stone, more time has passed, three and a half hours.
Well, I went to the hospital, told my wife that she had brought me the ingredients I needed, by five o'clock she brought everything to me, brought it to the ward and, mixing the drugs, told everyone that this was the most effective way, explained the validity period and accepted ...

I’ll say right away, only one person followed me and the time. I didn’t even run or jump, lay stupidly and watched Soviet cartoons in the tablet (when should I watch them then ...).

Three hours passed, a little more ... Seeing that they were following me, I apologized, saying that the recipe did not work and everything connected with it ..

I took a jar and went to the toilet (the jar is needed to catch stones), first into the jar, then pour it into the toilet. When the bladder was released, the pebble triumphantly hit the wall of the jar.

The rumor about my recipe swept through the floor in half an hour ... In the morning, a consultation was held, and therefore the round was delayed by three hours.

The next morning, while standing in line to donate blood, I explained to everyone that they needed plain oil, not rapeseed and not palm oil and not unrefined and refined ... I do not like fame ...

Once again, the recipe - pour 2 tablespoons of sunflower oil into a glass (or into any form convenient for you), squeeze half a lemon into the same vessel, shake well and inside with one gulp!

Yes ... To use after the symptoms of cuts similar to cutting off a bridle with a blunt knife (men will understand). This is not a preventive measure! I will tell you about prevention and types of stones in the next post.

Pain in the side against the background of kidney stones becomes quite pronounced when a kidney stone goes through the ureter. What to do and how to relieve pain? Especially if the calculus gets stuck in the ureter.

Causes of pain

The main causes of severe pain in the side or lower back when a stone is moved from the kidney to the ureter are the following:

• The stone gets stuck in the ureter, blocking the flow of urine.
• Stagnation creates conditions for the accumulation of urine in the renal pyelocaliceal system.
• An increase in intralocal pressure leads to irritation of nerve receptors.
• The blood flow in the renal arteries is impaired, which is the cause of ischemia of the renal parenchyma.

If there is a kidney stone, then the pain will be comparable to the sensations of a woman during the laborious period of labor. With one significant addition - with the birth of a baby, pain disappears, and with a stone stuck in the ureter, severe pain lasts a long time and does not immediately disappear even during treatment.

Symptoms when the stone is displaced

Macroliths or coral stones are inactive, so it is extremely rare for a large calculus to move towards the ureter. The sand will come out of the kidneys with minimal sensation. Usually, pain occurs when microliths are moved, the size of which does not exceed 10 mm. The movement of a stone from the kidney to the ureter is triggered by the following factors:

• one-time abundant fluid intake;
• running or brisk walking;
• jumping or playing sports;
• riding a bicycle or motorcycle on rough terrain;
• pronounced shaking when driving a car on a bumpy road.

Suddenly onset pain primarily occurs in the lower back or in the side, but almost immediately begins to move downward through the lower abdomen into the groin and thigh. A person cannot find a comfortable position - with any change in the position of the body, nothing changes. The severity of the pain syndrome is so strong that screams and moans are possible. It is at this moment that first aid should be provided before the doctor arrives, but you just need to know what can and cannot be done.

First aid measures

Before a doctor arrives, the main thing to do is to try to relieve the pain. However, all methods of pain relief can be used only with 100% certainty that the pain syndrome is caused by the passage of a kidney stone. This is usually possible with repeated episodes of renal colic.

If severe pain in the right side appeared for the first time and no kidney stones were previously examined for kidney stones, then the only option for emergency care would be to take any antispasmodic drug. This measure will somewhat reduce the intensity of the pain syndrome. The emergency doctor will be able to distinguish the movement of a stone from the right kidney from an acute appendicitis or an attack of gallstone disease.

If the pain is on the left, then taking strong painkillers will hide from the doctor acute conditions not associated with the kidneys (perforation of hollow organs, intestinal obstruction, spleen infarction). Back pain and lower back pain can be with pathologies of the spine (dorsopathy, osteochondrosis, herniated disc).

If the diagnosis of nephrolithiasis was made earlier and the stone comes from the kidney is not the first time (repeated episode of renal colic), then the following means can be safely used:

• any method of thermal procedure on the painful area (hot water bottle on one side, bath with water temperature about 40 °);
• oral administration of drugs with anesthetic and antispasmodic effect;
• it is advisable to use injectable drugs, but only if there is a medical professional nearby who can give intramuscular or intravenous injections.

Even if the acute pain has disappeared, one cannot refuse to see a doctor and carry out further treatment in a hospital. This is necessary due to the following factors:

• getting rid of unpleasant sensations is not at all a criterion that the stone has come out of the kidney;
• if calculus comes from the kidney, then this is always accompanied by difficulty in the outflow of urine, which can cause dangerous complications (hydronephrosis, acute pyelonephritis with suppuration, renal failure);
• after the end of the analgesic effect, the pain will return with renewed vigor.

In contact with

Kidney stones can pass through the urine. However, this is a lengthy process that should not be allowed to take its course, because if the calculus is large, its movement along the ureter often causes extremely adverse health consequences.

The movement of calculi is accompanied by the following characteristic signs:

• thick urine, later becoming liquid and light;
• a yellow or red sediment forms in the urine;
• there is a sharp pain;
• body temperature rises;
• there is nausea with vomiting;
• blood pressure rises;
• dizzy;
• chills occur.

Kidney stones can vary greatly in size and shape. Sometimes they are grains of salt, but stones with uneven edges with a diameter of 5 mm or more are often formed from small particles. While the formations do not move, they do not manifest themselves in any way. However, the exit of kidney stones in adult men and women is accompanied by debilitating pain: the stones change their position and scratch the internal organs with sharp edges.

The main danger is that the formations in the kidneys begin to move suddenly, and not only under the influence of special drugs. This process is provoked by stress - for example, lifting weights, a sharp change in body position, exercise.

Pain occurs in the lumbar region and radiates to the groin, thighs. The calculus creates an obstacle for the free movement of urine, so there are difficulties when urinating. This process also becomes painful, in addition, the frequency of urge to use the toilet increases.

If fine sand begins to move, most often no signs are observed. When a large stone comes out, very severe pains begin in the kidneys. The most severe cases may be accompanied by other symptoms. Among them there is a high body temperature, loose stools, vomiting.

These symptoms usually do not last long. They can periodically appear and disappear again. Foreign body movement and urine hardening cause increased urge to use the toilet.

When a stone moves from the bladder down the ureter, the flow of urine is blocked. Sometimes symptoms of acute renal failure appear. In addition, when a calculus leaves the bladder, a burning sensation is often observed. If the foreign body has sharp edges, it will scratch the organs as it travels, resulting in drops of blood being fixed in the urine.

First aid

By studying information about how kidney stones pass, it is easier to recognize the symptoms. This will help to competently provide first aid - to yourself or to a patient.

1. Water procedures.
2. Poultices.
3. Herbal infusions.
4. Compresses.
5. Applications.

To alleviate the pain syndrome and relax, it is recommended to sit for 20 minutes in a bath with warm water and drink an infusion of dill seeds. However, this method is contraindicated at elevated temperatures. After water procedures, you should eat radish with honey every 2 hours.

It also eases the patient's condition with a poultice of boiled potatoes, applied to the painful area. If there is blood in the urine, it is helpful to apply an ice-filled bladder. You can poultice with a hot water bottle.

If kidney stones come out, then they use such proven folk remedies as compresses from oatmeal and cabbage leaves, as well as clay applications. They contribute to the stretching of the ureters, so the severity of the pain syndrome decreases. To remove toxins from the body, it is useful to do enemas. An effective remedy for oral administration is considered to be an aqueous infusion of oak bark and wild pear leaves. When a stone has come out of the bladder, it is also recommended to do warm foot baths and mud wraps.

If small stones with a diameter of up to 5 mm can leave the bladder on their own, then larger stones block the transport of urine. Without appropriate treatment, this can lead to an abscess, general intoxication and subsequent death. At the same time, in the presence of renal calculi, infection and pyelonephritis often develop. In such cases, folk remedies will not help - it is necessary to use antibiotics, which the doctor should prescribe after the tests.

Since kidney stones come out with pain that can be very severe, it is advisable to take pain relievers. At the same time, it is important to correct the diet, excluding junk food, and give up alcohol.

Diet

Studies in men and women with kidney stones make it easier for a foreign body to escape when dieting. Also, in case of kidney formations, it is recommended to drink 2 liters of water every day.

A special diet is important in order to exclude unnecessary stress on the internal organs, which are already working hard, neutralizing the negative effects of drugs. The following food is subject to an exception for calculi in the kidneys:

• dairy products;
• meat;
• hen;
• foods rich in oxalic acid.

Milk-based products should be avoided for kidney formations, because they are rich in calcium, and most of the stones are formed from it. Patients should not eat a lot of hard cheeses, butter, fatty cottage cheese, sour cream. At the same time, it is necessary to stop taking calcium supplements used to strengthen bones.

Meat for kidney stones should not be abused either. This product is rich in animal protein, due to which the concentration of calcium in the urine increases. It is better to completely abandon the chicken. Especially dangerous for kidney stones are foods rich in oxalic acid: tea, chocolate, citrus fruits, coca-cola, rhubarb, sorrel.

It is useful for urolithiasis to eat carrots, as it replenishes the deficiency of vitamin A. It is also recommended to increase the intake of magnesium and vitamin B6 in the body, since these substances reduce the concentration of oxalates in the blood.

When is surgery required?

When the stones go by themselves, it is possible to avoid surgery. While they are small, you should start taking emollients. In order not to miss complications, patients are advised to regularly see a doctor and undergo diagnostics.

It will be necessary to perform an operation so that the stone comes out only if conservative methods have proved to be ineffective. This rarely happens if treatment is started on time.

Surgery is necessary for the stone to come out of the bladder or kidney with a completely blocked urinary tract, with purulent complications and the development of renal failure.

In order not to start the disease to the stage at which the kidney will have to be removed, it is important to follow a diet and drinking regimen, as well as regularly get tested.

In case of kidney stone disease, it is useful to know how the stone leaves the kidney and what symptoms accompany this process. This will allow, upon detection of characteristic signs, to alleviate the condition with the help of poultices and decoctions. With severe pain and vomiting, you should not self-medicate, since a large calculus began to move. In this case, it is better to immediately seek medical help, otherwise surgery may be required.

This material is for educational purposes only and should not be used as a guide to the diagnosis or treatment of renal colic at home. All medical and diagnostic activities should be carried out under the supervision and with the participation of a certified urologist.

In addition, even with "banal" urolithiasis, serious complications are possible, which, if inadequate or untimely treatment, can lead to the loss of a kidney or even death.

General issues.

What is renal colic?

Let us turn to the textbook of urology for students (Lopatkin NA): “Renal colic is an attack of acute pain, the most characteristic symptom of kidney and ureteral stones. It is caused by a sudden cessation of urine flow caused by a blockage of the upper urinary tract with a stone.

What are the manifestations of renal colic?

The most common, albeit optional, sign of renal colic is acute onset. Intense pain in the lower back (on the one hand) arises suddenly, for illustration I will allow myself to quote the words of one of the patients: "I was driving in an elevator, and suddenly it caught me so that I sat right on the floor ...". The pain is constant, does not go away from a change in body position. Attempts to find a position in which the pain would decrease are ineffective. Bilateral renal colic is possible but extremely rare.

Having once experienced an attack of sudden severe pain in the lumbar region, a person will remember them until the end of his days. In terms of the intensity of pain, renal colic can only be compared with myocardial infarction or perforation of a stomach ulcer. Often, patients with renal colic are transported from the ambulance to the urologist's office on a gurney, since it is difficult for them even to walk because of the pain. For pain relief, as a rule, drugs such as analgin, no-shpa or ketorol are traditionally used, but in some cases pain can only be relieved with opiates.

In addition to pain, renal colic may be accompanied by the appearance of blood in the urine (hematuria), nausea and vomiting, and frequent urination in small portions (pollakiuria or dysuria).

At the same time, there are cases when the passage of a kidney stone with impaired outflow of urine through the ureter passes without pronounced symptoms. Patients describe their complaints very vaguely, they cannot clearly indicate the side and nature of pain. Such renal colic, detected incidentally, for example, by ultrasound, is called atypical.

Why does vomiting often occur with renal colic?

The reason lies in the anatomy, or rather, in the structure of the nervous system. The kidneys, like the gastrointestinal tract, are innervated by the celiac plexus (sometimes also called the solar plexus). Intense irritation of this plexus in case of impaired outflow of urine from the kidney is similar to irritation of the stomach or intestines in case of, for example, poisoning. Vomiting occurs reflexively. That is, our body is trying to get rid of the irritant in this way. As a rule, vomiting brings little or no relief. With severe nausea, the drug cerucal is prescribed (which in Western countries is part of the standard treatment for renal colic). For the same reason, due to irritation of the celiac plexus, when the stone passes through the ureter, constipation and bloating may occur, which requires adherence to a certain diet, which will be discussed below.

Why does it feel like you constantly want to go to the toilet?

Again, the whole point is in the peculiarities of innervation. The so-called "false desires" that occur with renal colic are associated with irritation of the nerve endings in the ureter when the stone reaches its lower third. At the same time, there may be pain in the groin, in the scrotum, in the head of the penis. As a rule, these sensations disappear immediately after the stone leaves. The appearance of frequent urination with renal colic is a good prognostic sign; most likely, the stone has passed almost the entire length of the ureter and is in the immediate vicinity of the bladder. At the same time, it should be remembered that the narrowest part of the ureter is the junction with the bladder (the so-called juxtavesical and intramural sections). To clarify the location and size of the stone, excretory urography is shown.

What diseases can cause renal colic?

The cause of renal colic is a violation of the outflow of urine through the ureter. In the overwhelming majority of cases, it is a ureteral stone, but similar pains can also occur when the ureter is blocked by a blood clot, for example, with an injury or tumor, with a severe course of purulent pyelonephritis with such a rare complication as necrotizing papillitis, with tuberculosis, with a tumor of the ureter or urinary bladder with narrowing of the lumen of the ureter. In addition, renal colic can occur when the ureter is ligated during an operation on the pelvic organs (for example, extirpation of the uterus), which, unfortunately, is not so rare, or due to external compression of the ureter by enlarged lymph nodes or a retroperitoneal tumor.

How can you provoke an attack of renal colic?

Usually our patients find it difficult to answer what, in their opinion, could provoke an attack of renal colic. Pain can appear during rest, at rest, in sleep, or while performing everyday, habitual activities. Sometimes a seizure is preceded by a long drive on a shaky road, water load (for example, a watermelon eaten or drunk beer), a stab in the back or a fall (including due to an accident) - that is, factors that can "move" a stone. From personal experience, I can say that I have repeatedly observed how renal colic (more often saline, passing after a few hours) arose soon after the start of taking herbal preparations aimed at preventing urolithiasis.

Pregnancy can also contribute to the passage of kidney stones due to the physiological expansion of the upper urinary tract seen in the third trimester.

And yet, in the vast majority of cases, renal colic occurs spontaneously, without any provoking factors.

What is the mechanism of pain in renal colic?

The pain occurs due to impaired blood circulation in the kidney due to a sharp increase in pressure in the collecting system. The following happens: urine continues to flow into the renal pelvis, it cannot pass through the ureter, as a result the enlarged pelvis and calyx "expands" the kidney from the inside, which leads to compression of the renal tissue and the vessels passing through it. Pain similar in mechanism and intensity occurs during myocardial infarction, when blood circulation in the corresponding area of ​​the heart muscle is impaired due to blockage of the coronary vessel.

The intensity of pain does not depend on the location or size of the stone. A severe attack of renal colic can be caused by the discharge of a stone, the diameter of which does not exceed 1-2 mm. Therefore, among urologists, the expression is widespread: "Stones are like dogs: the less, the angrier."

What diseases are similar to renal colic?

Pain similar to renal colic can be caused by acute appendicitis, ectopic pregnancy, torsion of the ovarian cyst, acute pleurisy, pneumonia, kidney infarction, herpes, osteochondrosis, myocardial infarction, and so on. It is obvious that self-medication is unreasonable and dangerous, especially since renal colic has clear signs that are detected during a standard instrumental examination in a hospital setting. Treatment should be carried out only after an examination confirming the diagnosis, preferably under the supervision of a hospital urologist, who has the ability to hospitalize the patient if necessary.

What is the reason for the appearance of blood in the urine?

The appearance of blood in the urine (hematuria) is caused by traumatic damage to the wall of the ureter by a stone and is a very characteristic, but not an obligatory sign of renal colic. In the case of a complete blockage of the kidney, when urine completely stops flowing into the bladder due to a stone, or when the stone has a smooth surface, a general urinalysis may remain normal. Conversely, with bleeding from the kidney, renal colic itself may be caused by blockage of the ureter not by a stone, but by blood clots.

Can a stone leave the ureter and remain in the bladder?

This is possible, but unlikely. The lumen of the urethra is much wider than the lumen of the ureter, so stones usually do not linger in the bladder. But, as you know, there are exceptions to any rule. In a number of conditions, and, above all, in the presence of BPH (prostate adenoma) or urethral stricture, the likelihood of a stone retention in the bladder increases dramatically. In most cases, such a stone is removed through the urethra without resorting to open surgery.

Diagnostics

What diagnostic methods are used for renal colic?

The beginning of any examination is an examination of the patient and clarification of the history of the disease (anamnesis). Thirty years ago, the aphorism was popular among doctors: "A thoroughly collected anamnesis is half the diagnosis", however, in the 21st century, of course, the leading role in the diagnosis of renal colic belongs to ultrasound examination (US) of the kidneys and X-ray of the urinary system with a contrast agent (so called excretory or intravenous urography). In addition, a general urinalysis and a complete blood count are performed.

What does the inspection reveal?

In a patient with renal colic, examination can reveal soreness in the kidney area, sometimes along the ureter, in addition, the examination allows, as a first approximation, to exclude acute surgical diseases, and in men - such diseases with colic-like manifestations as acute prostatitis and diseases organs of the scrotum.

What information does ultrasound (ultrasound) provide?

Ultrasound examination impresses with its safety, availability, low cost and the ability to quickly, sometimes in a few seconds, confirm the presence of renal colic.

The most striking and often observed sign of renal colic on ultrasound is the expansion (dilatation) of the collecting system of the kidney. Sometimes you can see stones in the uppermost or in the lowermost part of the ureter or directly in the kidney or bladder, in addition, ultrasound allows you to exclude a tumor of the kidney or bladder, assess the condition of the renal parenchyma, surrounding tissue, kidney mobility, etc.

Unfortunately, far from all patients with renal colic, we observe a characteristic ultrasound picture, which may be associated with the peculiarities of anatomy (for example, the presence of an intrarenal pelvis) and with the duration of renal colic (after several days, the expansion of the collecting system may disappear, although the stone with this remains in the ureter, and the kidney does not excrete urine) and simply with insufficiently good conditions for ultrasound (for example, in patients with obesity or with increased gas production). In addition, as a rule, ultrasound does not allow assessing the state of the ureter along its entire length and identifying the stone in it, as well as determining its size. That is why it is necessary to combine ultrasound of the urinary system with excretory urography.

What is excretory urography?

The gold standard in the diagnosis of renal colic is X-ray examination of the urinary system with contrast (excretory urography). It is performed as follows: first, a picture is taken without a preparation ( plain urography), then a radiopaque substance ( contrast), which has two remarkable properties: firstly, it is very quickly captured by the kidneys and excreted in the urine, and secondly, this substance does not transmit X-rays. Thus, taking pictures after the introduction of contrast, we can trace the movement of urine along the urinary tract and identify or exclude the presence of an obstruction (stone) in the ureter. In addition, we receive important information about the anatomy of the urinary tract, the condition of the opposite healthy kidney, and more. Most often, with renal colic, with the help of this study, it is possible to clearly trace where the stone is and what its dimensions are, and, therefore, to assess the likelihood of its separation on its own against the background of the stone-expelling therapy being carried out.

Contraindications to excretory urography are thyrotoxicosis (increased thyroid function) and iodine allergy. In addition, excretory urography is not performed in the presence of chronic or acute renal failure, as well as in low blood pressure.

Why is a general urine test and a general blood test performed?

First of all, to exclude the inflammatory process in the kidney. Violation of the outflow of urine from the kidney creates favorable conditions for inflammation (the so-called obstructive pyelonephritis), which is manifested by fever, general malaise and characteristic changes in urine and blood tests. The likelihood of developing acute pyelonephritis depends on a number of factors, including gender: in men it is ten times less than in women. In addition, in case of doubt about the diagnosis, the appearance of blood in the urine serves as an additional argument in favor of renal colic.

What is "saline" renal colic?

There are frequent cases when, after pronounced renal colic, relief comes very quickly, although it is not possible to catch the stone even with a careful examination of the urine sediment. Ultrasound and x-rays also do not reveal a stone, although all other signs of renal colic are present. In such cases, they talk about saline renal colic.

What other diagnostic methods are used for renal colic?

In addition to ultrasound and excretory urography, in rare cases, multispiral computed tomography (MSCT) with contrast enhancement and three-dimensional reconstruction is performed, as well as a radioisotope study of renal function - dynamic nephroscintigraphy. In addition, to assess the patency of the ureters, chromocystoscopy is sometimes performed (intravenous administration of a substance dyeing urine (indigo carmine) followed by observation of the area of ​​the ureteral orifices) or the ejection of urine from the orifices is recorded during Doppler scanning. However, ultrasound and excretory urography are still routine methods.

Treatment

What can you do with renal colic at home before the ambulance arrives?

The simplest and most affordable remedy for an attack of renal colic is a hot bath or shower.

Since the ambulance does not always arrive quickly, especially in such a congested city as Moscow, and the pains are unbearable, you need to know how you can alleviate your condition before the doctor arrives. To reduce pain, traditional drugs are used: no-shpa, baralgin, dexalgin, ketonal.

Neither attempts to find a "comfortable position", nor artificially induced vomiting, nor an enema or gastric lavage with "potassium permanganate" (sometimes this happens) bring relief. In a hospital setting, a variety of drugs are used for pain relief, including (rarely) and narcotic drugs.

How is renal colic treated?

First of all, it is necessary to determine what disease caused renal colic. In most cases, it is urolithiasis (Urolithiasis). The examination makes it possible to assess the size and location of the stone, sometimes its composition, and determine the likelihood of its passage when prescribing appropriate therapy. If this probability is small, then the issue of surgical treatment is immediately considered, which is understood as a whole range of manipulations, ranging from distance lithotripsy (crushing using mechanical waves focused on the stone) and ending with open surgery. However, it should be noted that in urological clinics equipped with all modern methods of treating urolithiasis, open surgery is performed in less than 3% of patients.

What is stone expelling (lithokinetic) therapy?

If, during the examination of the patient, a ureteral stone is revealed, the size and location of which makes it possible to hope for its independent discharge, then drugs are prescribed that accelerate this process and alleviate the patient's suffering. Typically, the treatment regimen includes:

Antibiotics (for the prevention of pyelonephritis)

Antispasmodics (to dilate the ureter)

Alpha blockers (to relax the smooth muscle cells of the ureter)

Non-steroidal anti-inflammatory drugs (NSAIDs) (to relieve ureteral edema at the site of the stone and to relieve pain)

In addition, steroid hormones, calcium channel blockers, antiemetic drugs, herbal drugs, etc. are used.

Do I need to follow any diet while the stone is passing away?

Yes. When the stone leaves, we often encounter disruption of the intestines, which is associated with irritation of the celiac plexus. Most often, we are talking about constipation, bloating of the intestines, less often the discharge of the stone is accompanied by excruciating nausea and even vomiting, which can force you to abandon expectant tactics.

To normalize bowel function, it is necessary to refrain from taking gas-forming foods (black bread, cabbage, zucchini, legumes, drinks with a high sugar content, including juices and carbonated drinks).

Fluid consumption should be in the range of 1.5 - 2 liters.

In the absence of stool for 2-3 days, laxatives or a cleansing enema are prescribed.

What to do if the temperature rises while the stone is moving away?

A rise in temperature may be a sign of kidney inflammation (acute pyelonephritis). In such cases, hospitalization and drainage (ensuring the outflow of urine) of the kidney using a ureteral catheter or nephrostomy is necessary, after which antibiotic therapy can be carried out. Acute obstructive pyelonephritis is a dangerous and rapidly developing process. Kidney abscess, development of urosepsis and even death of the patient may be the result of untimely seeking help. In rare cases, for the development of purulent fusion of the kidney with the formation of an abscess, 2-3 days are enough, therefore, if a fever appears during the course of stone-expelling therapy, it is necessary to urgently consult a urologist to continue treatment in a hospital setting.

How long can you wait for the stone to come out?

We usually prescribe stone-expelling therapy for 10-15 days. If during this time she did not give a result, a follow-up examination and a revision of treatment tactics are necessary. As a rule, distance or contact lithotripsy is indicated, in some cases it is possible to continue conservative treatment. If the stone is in one place for a long time, then as a result of edema and inflammation of the ureteral wall, fibrosis (formation of scar tissue) develops, which, as it were, "fixes" the stone in this position. Such so-called "impacted" stones are difficult to crush, both with distance and with contact lithotripsy. Removing such stones is likely to cause injury to the ureter, which may require open plastic surgery.

Unfortunately, we often have to deal with a rather frivolous attitude towards this disease, both on the part of some doctors (more often not urologists) and on the part of patients. The consequences of such an attitude are very dire.

How can a stone be “helped” to leave the ureter?

First, let's talk about what not to do.

First of all, there is no need to try to "squeeze out" the stone with the help of abundant drinking, it is enough to keep the fluid intake at the level of 1.5-2 liters per day. (In the auditorium of the Urology Clinic on Pirogovka (MMA named after IM Sechenov) there is a poster: "Stones are driven not by urine, but by the doctor's skill"). The fact is that when a stone is in the ureter, the kidney practically does not work and all urine is excreted by the second healthy kidney. The advancement of the same stone is carried out due to contractions of the ureter similar to intestinal peristalsis.

Recommendations like “jump on one leg” or “run up the stairs” also make no sense, although at the beginning of the 20th century, industrially produced mechanisms were proposed to “shake out” stones from patients, which today are only of historical interest.

The main "help" to the stone is the precise implementation of the recommendations given by your urologist and adherence to the terms of treatment. If conservative therapy is ineffective within 10-15 days, hospitalization for lithotripsy is indicated.

What is extracorporeal lithotripsy (EBL)?

It is a method of destroying urinary stones using mechanical waves focused on the stone under X-ray or ultrasound guidance. The method has been in use for over 20 years and has proven itself as a first line method. The main advantage is its non-invasiveness, that is, there is no need to introduce any instruments into the patient's body. With the correct determination of the indications for the use of this method, the efficiency of extracorporeal lithotripsy exceeds 95%.

What is Contact Lithotripsy?

This is a method of destroying a urinary stone using a laser or mechanical energy transferred to the stone through direct contact with it. The method is invasive. Cystoscopy (instrumental examination of the bladder) is performed, then the ureteroscope is inserted into the ureter up to the stone. Crushing is carried out under the control of vision. This method is most effective for removing stones in the lower third of the ureter.

What is a "stone path"?

In ESWL (distance lithotripsy) of a ureteral stone, its fragments can form a "chain" in the lower segment of the ureter, which has a characteristic appearance on an x-ray and is called a "stone path".

Do I need to do something if the pain is gone, but the stone does not come out?

Yes. The ureteral calculus must be removed. In my memory, there are several patients in whom, in the absence of any complaints, we found "forgotten" ureteral stones.

This situation always leads to the death of renal tissue due to the development of hydronephrosis. All these cases ended with the removal of the stone together with the ureter and kidney (nephrectomy), therefore, if 2-3 weeks after the start of stone-expelling therapy the pain disappeared and the stone did not come out, it is necessary to perform excretory urography - the simplest and most accessible method for assessing the condition and patency ureters.

What are the possibilities for the diagnosis and treatment of renal colic in the GKB im. S.P. Botkin?

Currently, we can proudly say that our hospital has all the existing modern methods, both for diagnosis and treatment of urolithiasis. In most cases, to make a decision on the tactics of treating urolithiasis, we perform ultrasound of the kidneys and excretory urography. In difficult situations, multispiral computed tomography (MSCT) can be performed.

In four urological departments of S.P. Botkin, we have two installations for distance lithotripsy (stone crushing), equipment for contact laser lithotripsy. Since 1986, at the urological clinic of the S.P. Botkin, endoscopic (through a puncture in the lumbar region) methods of removing stones from the kidneys (percutaneous puncture nephrolitholapaxy (PPNL)) are widely used. This method can be used to remove kidney stones of any size, including coral ones.

Prophylaxis

How can you avoid recurrence of renal colic after the stone has passed?

The likelihood of recurrent renal colic is not so great. So, according to the results of one of the studies, when observing for 10 years for patients who have had renal colic, repeated attacks occurred only in 25%. Following simple recommendations will greatly reduce the risk of recurrence of urolithiasis. First of all, we are talking about the drinking regimen and dynamic observation (periodically (every 3-6 months) performed by ultrasound of the kidneys and general urine analysis). In some cases, drugs are prescribed for drug prevention of urolithiasis (Urolithiasis).

What is a "drinking regimen"?

Obviously, the larger the volume of urine excreted per day, the lower the concentration of salts dissolved in it and, therefore, the less likely the formation of new stones. Therefore, we recommend that all patients with urolithiasis increase their fluid intake. This is what is called the "drinking regimen".

If you have a predisposition to the formation of kidney stones, you should drink at least 2-3 liters of fluid per day, and even more in hot weather. It should be understood that the formation of urine is not the only way to remove water from our body, although it is the most obvious. Even in normal cold weather, together with exhaled air, stools and then, we lose about 25-30% of the water we drink. In summer, in the heat, fluid intake should be increased so that the daily urine volume is at least 1.5-2 liters.

The easiest way to assess whether you are drinking enough is to observe the color of your urine. If it is almost colorless or slightly yellow, you are drinking enough. Conversely, a deep yellow urine indicates that your chances of reliving renal colic are very high.

What medications are used to prevent urolithiasis?

There are a number of drugs proposed for the prevention (more precisely, metophylaxis - prevention of recurrence) of urolithiasis, however, there are no clear recommendations for determining the indications for their intake and the duration of treatment. After determining the type of stone, drugs are prescribed that affect the pH of urine, xidiphon, madder dyeing, Uralit-U, blemaren. With a tendency to form urate stones, allopurinol is used to lower the level of uric acid in the blood. The most popular among urologists are herbal preparations: phytolysin, half-fallen, cyston, Kanefron N. This choice is explained, first of all, by the safety of treatment. The appointment of a specific drug and the duration of its administration are determined individually based on the patient's age, the nature of the stones, the presence of concomitant pyelonephritis, etc.

In Russia, these are the Caucasian Mineral Waters, primarily Zheleznovodsk. For people who have the opportunity to spend their holidays outside our homeland, we recommend the Italian resort Fiuggi, when visiting which you can combine rest and treatment with an interesting excursion program. As our experience shows, Fiuggi mineral water helps to eliminate small kidney stones, normalize urine tests and has a beneficial effect on the course of chronic pyelonephritis.

People who are diagnosed with nephrolithiasis should know how kidney stones pass. The fact is that the process of movement of calculi along the ureters and urinary tract can be very painful and even dangerous for the patient's health. Therefore, it is important to know what symptoms accompany the release of kidney stones, and what needs to be done to alleviate your condition.

Why are kidney stones dangerous?

The kidneys are an important organ system that filters all body fluids and excretes harmful substances in urine. In the process of purification, some chemical elements are deposited in the kidneys, and over time they turn into sand. When grains of sand accumulate under the influence of the acidic environment of urine, stones are formed, which can reach large sizes.

The main problem is that the stones are not in a stable position and sometimes begin to move along the urinary tract. The ureter is the narrowest point; in an adult man, its diameter is approximately 0.8 millimeters. This makes it difficult for kidney stones to escape, as many of them sometimes grow up to 1 centimeter in diameter.

Moreover, stones can have various shapes and sharp ends, which, when moving along the ureters, can touch its walls, causing pain to the patient. If the stone is too large, it simply gets stuck, blocking the flow of urine.

The process of leaving stones in most cases is accompanied by painful sensations. Sometimes the pain can be very severe and even unbearable. If the kidney stone is very large and has sharp corners, its movement can be very dangerous, because during its movement, damage to the walls of the urinary tract is formed, into which infection from urine can easily penetrate. This will inevitably lead to the development of an inflammatory process in the urinary tract.

Kidney stone symptoms

People who have kidney stones should be especially careful, because sometimes even small physical activity provokes the movement of stones along the urinary tract. However, the problem is that not everyone knows about the presence of the disease before the onset of painful sensations due to renal colic.

Most patients find out too late that they have kidney stones, when drug treatment can no longer help, and urgent measures must be taken to eliminate stones from the urinary tract.

There are some signs by which you can understand that there are stones in the kidneys:

• Frequent pain in the lumbar region with a pronounced aching character.
• Frequent urge to use the toilet.
• Painful sensations during the emptying of the bladder.
• Pronounced dark or yellow urine, not transparent.
• The appearance of blood particles in the urine.
• Changes in the characteristics of urine directly during urination. For example, a change in color or density.

These signs may indicate the presence of kidney pathology, therefore, if they are detected, it is necessary to contact a specialist to prescribe a full examination.

It is important to understand that calculi coming out of the kidneys can provoke severe pain, which will manifest itself with the slightest movements. In addition, when the urinary tract is clogged with kidney stones, there is a great danger that intoxication of the body will occur, or, in other words, self-poisoning. When urine does not leave the body, the toxic components contained in it begin to enter the internal organs, which leads to the appearance of various diseases and ailments.

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Can urolithiasis appear in children?

Many parents are interested in whether a kidney stone disease can appear in a child, and what to do if the kid starts to get stones from the kidneys. It is worth noting that kidney stones in children nowadays are formed quite often. This happens for several reasons:

• Bad heredity.
• Disorders in the development of the fetus during the period of being in the womb.
• Complications after infectious or inflammatory diseases.
• Wrong, unbalanced diet.

One of the first signs of kidney stones in a child is a dysfunction of the parathyroid glands, as well as problems in the digestive tract. These symptoms should be a signal for parents to take the child to a doctor for examination.

It is by no means possible to start the treatment of urolithiasis on your own, since you first need to go through a number of procedures to identify the size and quality of stones. Only after that will the specialist be able to select medicines to dissolve the stones or to prescribe an operation.

How to understand that stones have come out of the kidneys?

The passage of kidney stones is always accompanied by many symptoms. You can understand that the movement of calculi along the urinary tract has begun by the following signs:

• severe pain;
• acute pain in the lumbar region and kidneys, which can radiate to the groin area and thighs;
• renal colic;
• increased body temperature, chills;
• constant urge to urinate;
• severe burning sensation;
• the appearance of blood in the urine.

The movement of a kidney stone along the ureter can take a long time. At least this process lasts a week, maximum - a month (depending on the size of the calculus). At the same time, a new stone will (most likely) form in the kidneys at this time, which will then also begin to move along the urinary tract. If, after the release of the kidney stone, the patient does not take any action regarding the solution of the problem and treatment, there is a high probability that the situation will repeat itself.

After the stone leaves the kidney and urinary tract, all unpleasant symptoms gradually disappear. The patient's severe pain disappears, the general condition of the body is normalized, the body temperature returns to normal and the normal process of urination is restored.

Large stones can become lodged in the ureters, stopping further movement and obstructing the flow of urine. This problem is solved only surgically and in a short time, otherwise, due to intoxication in the body, the development of many other diseases will begin.

What to do if a kidney stone comes out?

If the patient has already been diagnosed with kidney stones, the patient should be prepared for the stones to begin to come out. This happens, as a rule, unexpectedly, so it is better to prepare in advance. Only a doctor can tell in detail about what to do if stones begin to move along the urinary tract. The first step is to purchase a number of drugs that will alleviate the patient's condition:

First, it is recommended to take pain relievers, for example, oral administration. Then you can connect antispasmodics, however, it is better to put them in an injection so that the remedy works faster. Well, after taking the drugs, you can start drinking herbal decoction.

A warm bath can also help relieve spasm in the ureter. However, do not lie in the water for too long, the procedure should take no more than half an hour. In this case, it is advisable to drink more diuretic decoctions so that the stone moves faster along the paths.

After carrying out this procedure, a number of special exercises are allowed. As a rule, patients are advised to walk up the stairs or squat, as such physical activity accelerates the passage of stones from the urinary tract. However, it is better to first discuss a set of exercises with your doctor so as not to harm yourself.

During urination, it is recommended to collect urine in a special container. Thus, the patient will not miss the exit of the stone and will be able to see blood impurities in the urine, if any. This sign suggests that there is wall damage in the urinary tract. On this fact, it will be necessary to undertake treatment aimed at disinfecting and preventing the development of the inflammatory process.

The stone itself will definitely need to be shown to the doctor. The specialist will prescribe a laboratory study that will determine the qualitative composition of the calculus. The research results will be used for further treatment of the patient. After all, it is likely that there are other kidney stones.

After the release of the calculus, the patient is necessarily assigned an ultrasound examination to determine the internal state of the organs of the genitourinary system, as well as the detection of other stones.

In addition, the patient is required to be prescribed a course of therapy, as well as a number of procedures at the resort, which will bring health back to normal. If an infection has been brought in during the stone release, the doctor also prescribes antibiotic therapy. The patient is prescribed a specific diet and lifestyle that will prevent further formation of kidney stones.

A frequent occurrence in urolithiasis is renal colic. Usually it is preceded by a number of adverse factors, for example, heavy lifting, sudden movements, shaking driving or psycho-emotional stress.

When renal colic occurs, a very sharp and excruciating pain appears, which has a paroxysmal nature. Usually, the location of the pain indicates the location of the stone, but its typical location is the lower back or ureters.

The cause of renal colic is mainly urolithiasis, but it can also be provoked by gynecological diseases, acute processes in the kidneys (pyelonephritis), a tumor or kidney injury, as well as various retroperitoneal inflammatory processes. Also, the lumen of the urinary tract can be a provoking factor with mucus or pus, a blood clot, necrotic areas of tissue, clamping of the ureter or a spasmodic reaction in the renal pelvis.

Renal colic is observed when a calculus overlaps the lumen of the urinary tract and a violation of the outflow of urine from the overlying sections. This leads to an excessive increase in pressure in the parenchyma, its edema and overstretching of the kidney capsule.

Clinical signs and symptoms

The symptoms of kidney stones coming out are renal colic. It is usually caused by stone movement and muscle spasm caused by this movement.

Colic has very characteristic features:

• Excruciating cramping pains in the area of ​​the projection of the kidneys;
• Pain can be given to the groin, iliac region, inner thigh, and also to the genitals;
• Frequent and predominantly false urge to urinate, while urine may not come out at all or be released in drops;
• Abdominal muscle tension;
• The patient tosses about on the bed - no position brings relief.

Sometimes the cause of colic is not the release of a stone, but the removal of a large amount of "sand" - very small crystals. The pain increases with the movement of the stone and decreases somewhat when it stops. Stopping the stone, as a rule, occurs in places of physiological narrowing of the urinary tract - when the cups pass into the pelvis, at the intersection of the ureters with large vessels, before entering the bladder (then tenesmus occurs - false painful urge to defecate), at the entrance to the bladder (pain radiates to the penis or clitoris, there is an intense urge to urinate). An extremely rare occurrence - mirror pain - it occurs in a healthy kidney.

In addition to colic, dyspeptic symptoms appear (nausea, urge to vomit, gas retention and reflex constipation), the temperature may rise to high numbers, the pulse may decrease against a background of moderately high blood pressure.

1. Take a warm bath - it removes the spasm and helps to subside the pain;
2. To relieve a painful attack, you can make an intramuscular injection of no-shpa, baralgin, analgin, papaverine with platifillin, metamizole, pitofenone, fenpiverinium.

Phytopreparations - cyston, cystenal, kanefron, phytolysin will also help alleviate symptoms, relieve inflammation and remove stones from the kidneys. They also have a mild diuretic effect and help dissolve stones. They should be taken depending on the form of release - 1-2 tablets, or 15-20 drops, or half a teaspoon of paste diluted in a glass of water.

How to get rid of kidney stones

With regard to permitted products, the doctor will be able to prescribe medical nutrition for kidney stones only after a repeated, proven acid-base reaction of urine for a long time, or after examining stones that came out during an attack of renal colic.

In addition, it should be borne in mind that most stones are polymorphic and contain several types of crystals, so the prescribed diet should take this point into account. A properly selected diet can further prevent recurrent episodes of renal colic.