What are the signs if there are stones in the bladder? Which doctor should I contact for urolithiasis? The mechanism of formation of stones in the bladder and their classification

At urolithiasis in the kidneys and bladder stones form, which can disrupt the functioning of the urinary system and cause various complications.

Urolithiasis affects 5–10% of people, men - 3 times more often than women. Typically, urolithiasis develops after 40–50 years of age. However, there are cases in children as well. Most often, stones form in the kidneys; the likelihood of their formation in the bladder is much lower. Most often, stones descend into the bladder from the kidneys through the ureters.

In this article we'll talk about stones in the bladder. Read more about another manifestation of urolithiasis - nephrolithiasis (kidney stones).

Bladder

The bladder is a hollow, spherical organ located in the pelvis that serves to store urine. Urine contains waste products that the kidneys filter from the blood. Urine is sent from the kidneys to the bladder through two tubes called ureters. When the bladder is full, urine leaves the body through a channel called the urethra (urethra). This is called urination.

Stones can irritate the walls of the bladder, blocking the passage of urine from it, impairing urination. This contributes to the development of infection and leads to pain in the lower abdomen, difficulty urinating, and the appearance of blood in the urine.

If any of the above symptoms appear, consult a doctor. These signs do not necessarily indicate urolithiasis, but a more thorough examination is necessary.

The most common cause of stone formation is incomplete emptying of the bladder during urination. If urine stagnates in the bladder for a long time, some of its components precipitate and form crystals, which eventually form stones.

Usually stones are removed from the bladder surgically. One of the common types of surgery is cystolitholapaxy.

Symptoms of bladder stones

If the stones are small enough that they can easily pass through the urinary tract and be passed out in urine, there may be no symptoms. However, in most cases, urolithiasis is accompanied by severe complaints, since the stones either irritate the walls of the bladder or interfere with normal urination.

Symptoms of urolithiasis include:

• pain in the penis, scrotum or lower abdomen (in men);
• pain or difficulty urinating;
• cloudy or dark urine;
• blood in urine.

Additional symptoms found in children include:

• constant and frequent painful erection not associated with sexual desire ( medical term for this condition - priapism) in boys;
• bed-wetting.

• constant abdominal pain;
• changing your usual urination pattern;
• blood in urine.

These symptoms do not necessarily indicate urolithiasis, but require a more thorough examination.

Causes of formation of stones in the bladder

The most common cause of stone formation is incomplete emptying of the bladder.

Urine is produced by the kidneys. It consists of water mixed with waste products of metabolism, which are removed from the blood by the kidneys. One of the decomposition products is urea, consisting of nitrogen and carbon. If urine sits in the bladder for a long time, some chemicals precipitate and crystals form. Over time, these crystals harden and form bladder stones.

Below are some of the most common reasons incomplete emptying Bladder.

Prostate adenoma (enlarged prostate gland). The prostate is a small gland found only in men. It is located in the pelvic area between the penis and bladder and surrounds the urethra (urethra), which carries urine from the bladder out of the body. The main function of the prostate is to participate in the production of seminal fluid. For many men, the prostate enlarges as they age.

Neurogenic bladder- a condition caused by damage to the nerves that control the bladder, resulting in a person being unable to empty it completely. Neurogenic bladder may have the following causes:

• severe injury to the spinal cord (the long bundle of nerves that runs inside the spine from the brain), resulting in paralysis (impairment motor activity organs and body parts);
• diseases that cause damage nervous system, for example, motor neuron disease or spina bifida (spina bifida).

Most people with a neurogenic bladder require a catheter to empty it. A catheter is a tube that is inserted into the bladder through the urethra. The catheter drains urine from the bladder. This is called bladder catheterization.

However, the artificial method of emptying the bladder is not an ideal replacement for the natural one. Therefore, the bladder may not contain a large number of urine, which over time causes the formation of stones. According to some estimates, about one in ten people with a neurogenic bladder will eventually develop urolithiasis.

Bladder prolapse- a disease that occurs in women and develops when the walls of the bladder weaken and begin to hang over the vagina. This may affect the normal flow of urine from the bladder. Bladder prolapse may develop during heavy loads, for example, during pregnancy, due to chronic constipation or heavy lifting.

Bladder diverticula- these are sac-like protrusions on the walls of the bladder. If diverticula grow to a certain size, a person may have difficulty emptying their bladder completely. Bladder diverticula can be birth defect or develop as a complication of infection or prostate adenoma.

Surgery to enlarge the bladder. There is bladder enlargement surgery, during which part of the intestine is sutured to the bladder. This technique is used, for example, to treat urgent urinary incontinence. Research results have shown that approximately every twentieth person who undergoes this operation will experience urolithiasis.

Monotonous food, rich in fat, sugar and salt, having a lack of vitamins A and B, can increase the susceptibility to urolithiasis, especially if a person does not drink enough fluids. These factors can change the chemical composition of urine, increasing the likelihood of bladder stones.

Treatment for bladder stones

Small stones can pass out of the body on their own; for this, it is recommended to increase the amount of fluid consumed to 6–8 glasses per day (about 1.2–1.5 liters). In other cases, medical attention will be required.

The most common surgeries to remove bladder stones include:

• transurethral cystolitholapaxy is the most common procedure for the treatment of urolithiasis in adults;
• subcutaneous suprapubic cystolitholapaxy - most often used to treat children to avoid damage to the urethra, but can sometimes be used in adults to remove very large stones;
• open cystotomy - often used for men whose prostate is so enlarged that it interferes with other procedures, or if the stone is very large.

These procedures are described in more detail below.

Transurethral cystolitholapaxy. During the operation, your surgeon will insert a cystoscope, a small, hard tube with a camera inside, into your bladder through your urethra. The camera will help you detect stones. Then, the stones are crushed into pieces using laser energy or sound waves, emitted by the cystoscope. Small pieces stones are washed out of the bladder with liquid.

Transurethral cystolitholapaxy is performed under local or general anesthesia, so you will not feel pain. There is a risk of infection during the procedure, so you will be given antibiotics as a precaution. There is also a small risk of bladder damage.

Subcutaneous suprapubic cystolitholapaxy. During the operation, the surgeon makes a small incision in the skin in the lower abdomen. An incision is then made in the bladder and the stones are removed through it. The procedure is carried out under general anesthesia.

Open cystotomy Similar to subcutaneous suprapubic cystolitholapaxy, but the surgeon makes a larger incision in the skin and bladder. An open cystotomy may be combined with another type of surgery, such as removing all or part of the prostate or removing bladder diverticula (sacs that form on the walls of the bladder).

The operation is performed under general anesthesia. The disadvantage of open cystotomy is more pronounced pain after surgery, more a long period recovery. But this procedure is necessary if the stone reaches large sizes. You will also need a catheter placed 1-2 days after surgery.

Complications during surgery

The most common complication of bladder stone surgery is the development of a bladder or urethral infection. These infections are known collectively as infections urinary tract.

Urinary tract infections occur in about one in ten people who have surgery. As a rule, they are treated with antibiotics.

After the bladder stones are removed, you will need to stay in the hospital for a few days so that your doctor can monitor your condition post-operatively. The length of hospitalization may vary depending on the type of surgery, complications, and your individual characteristics. You will be scheduled for a follow-up examination, during which an X-ray or CT scan will be taken to ensure that all stone particles have been removed from your bladder.

Treatment of the cause of urolithiasis

After removing stones from the bladder, it is necessary to treat the cause of the disease so that it does not happen again in the future.

BPH can be treated with medications that both shrink the prostate and relax the bladder, making urination easier. If medications don't help, you may need surgery to remove all or part of your prostate.

If you have a neurogenic bladder (inability to control your bladder due to nerve damage) and you develop urolithiasis, the way your bladder removes urine needs to be adjusted. This may require inserting a catheter or replacing an old one to improve bladder control.

Mild to moderate cases of bladder prolapse (when the bladder wall weakens and begins to droop into the vagina) can be treated with a pessary. This is a ring-like device that is inserted into the vagina and holds the bladder in place. In more severe cases, surgery may be required to strengthen and support the bladder walls.

Bladder diverticula (pouch-like protrusions) can be removed surgically.

Which doctor should I contact for urolithiasis?

Using the NaPopravku service, you can quickly find a urologist - a doctor who treats bladder stones. If surgery is necessary, choose a good urological clinic yourself by reading reviews about it.

Urolithiasis (ICD, urolithiasis) is a pathology characterized by the formation of stones (calculi) in the kidneys and bladder with their subsequent migration through the urinary tract.

The disease is widespread. The incidence of urolithiasis is high in Central Asia, countries of Africa and Eastern Europe, Kazakhstan, the Volga region, the Urals, the Mediterranean, Brazil, the USA, and the Far North.

The disease occurs in people of all ages and both sexes. There are known cases of urolithiasis in newborns. Women get sick somewhat more often than men. In childhood and old age, stones are more often diagnosed in the bladder, in middle-aged people - in the kidneys. Children become ill at the age of about 7-12 years; in them, KSD is manifested by dysmetabolic nephropathy: the accumulation of “sand” in the kidneys.

Symptoms

Unlike kidney stones, bladder stones are characterized by clear symptoms:

• Pain above the pubis, in the urethra during and after urination;
• Increased pain while walking, shaking, riding;
• At rest, the pain goes away. Symptoms of bladder stones do not bother you at night, during sleep. During the day the pain returns;
• Intermittent stream of urine (“voiding”);
• Compulsory urge to urinate;
• Urination occurs in a certain position of the body, often lying on its side. If something interferes with urination, it means the stone has moved down while standing. It will interfere with the normal flow of urine;
• Blood in the urine (hematuria). From small portions to heavy bleeding. The calculus injures the mucous membrane; when it is wedged into the neck of the bladder, which is rich in blood vessels, severe bleeding is possible. Then the entire portion of urine will be red;
• Incontinence of small portions of urine;
• Nagging pain in the lower back, above the pubis;
• Chronic cystitis accompanying the disease, characterized by frequent urination with pain, burning, false urges, worsens several times a year;
• If the sensations of pain intensify and become sharp, this is a sign that a stone is coming out of the bladder;
• The manifestation of “sand” in the bladder does not have pronounced symptoms; the discharge of cloudy urine with small grains of sand is more often noted;
• Symptoms of stones in the bladder in women are less pronounced than in men, which is associated with a short, wide urethra, which facilitates their rapid passage;
• Symptoms of stones in men are more pronounced, since the disease is often accompanied by prostatitis or adenoma. The urethra in men is narrow, long, and curved.

Reasons for education

According to their origin, bladder stones are divided into primary and secondary. Primary are those that form in the bladder itself due to certain reasons. Secondary - those that entered the bladder from the kidneys and lingered in it.

It is not difficult to guess where secondary stones come from: they are formed inside the cavities of the kidneys due to metabolic disorders, infection, and obstructed urine outflow. At any moment, the stone passes and moves down the ureter (the thin tube that carries urine from the kidney to the bladder), ending up in the bladder cavity. If there are obstacles to the outflow of urine, it can linger there for some time or forever. In the bladder, salts are layered on it, it enlarges, and symptoms of urination disorders appear. This is a secondary stone.

The causes of primary stones are varied:

• Infravesical obstruction is an obstruction to the free passage of urine from the upper urinary tract, located below the bladder. It is due to:
  • Prostate adenoma in men is a benign growth of prostate tissue, due to which it enlarges and compresses the urethra at the exit from the bladder, where it is located, interfering with normal urinary outflow. In men, signs of a stone are combined with symptoms of adenoma;
  • Prostate cancer. The reason is the same: compression of the canal by a dense, enlarged prostate with malignant foci;
  • Strictures (narrowings of the urethra). They can be congenital or acquired. The lumen of the urethra can narrow due to the growth of scar tissue after surgery on the prostate or the urethra itself. Urethral scars that impede the outflow of urine can form as a result of injury or a chronic infectious-inflammatory process. Gonorrheal urethritis often leads to this;
  • Urethral valves - a congenital disease associated with the formation of additional partitions inside the urethra;
  • Phimosis - narrowing of the foreskin. If with childhood in a boy or man, the head of the penis is not exposed due to cicatricial narrowing of the foreskin, urination becomes incomplete, and the outflow of urine becomes difficult;
  • Hypospadias is a congenital malformation of the penis, consisting in underdevelopment of the urethra (absence of its lower wall) and structure.
  • Foreign body of the urethra. This may be a previously stuck stone or an object inserted by the patient himself.
  • Uterine prolapse in women. A uterus that is in an incorrect position puts pressure on the urethra and does not allow full urination.
  • Urethral polyp - a common benign formation of the external urethral meatus in the elderly
  • Genital warts (genital warts) - a viral infection when growths form on the genitals and urethra
  • Tumors of the urethra or bladder neck.
• Due to operations to eliminate urinary incontinence in women, any bladder outlet obstruction leads to incomplete emptying of the bladder and the accumulation of residual urine, which healthy person there shouldn't be. With obstruction, the amount of residual urine sometimes reaches 500 ml or more. Stagnant urine is a fertile environment for infection and stone formation.
• Neurogenic bladder. This pathology occurs in patients with spinal injuries, diseases of the nervous system, and after strokes. The work of the bladder muscles becomes uncoordinated, and urinary retention occurs (hypotonic bladder, that is, the bladder muscle is unable to contract to expel urine, or urinary incontinence). At spinal injuries the person does not feel the urge to urinate. With a hypotonic bladder, there is also an accumulation of unremoved urine;
• Bladder diverticulum (acquired, congenital) is a hernia-like protrusion of the organ wall to the side, resulting in the appearance additional cavity with a narrow entrance where urine accumulates and stone forms;
• Abdominal bodies inside the bladder and long-term catheterization. A foreign body can enter during masturbation different objects. A urinary catheter is also a foreign body. A drainage stent (a thin internal catheter that is installed in the ureter and fixed at one end to the wall of the bladder) is also a foreign body. Salts accumulate on catheters and stents. This leads to encrustation (overgrowth with salts) followed by stone formation;
• Suture material on the walls of the bladder, remaining after previous operations on the organ. Stones form on the threads. They are called fixed;
• Prolonged immobility of the body for more than 6 months leads to the disease;
• The formation of stones in the bladder is facilitated by low fluid intake, which results in the formation of thick, concentrated urine, in which a suspension appears - an accumulation of salts, cholesterol, and bacteria. The resulting salt clots become denser and form stones.

Types of stones

Stones and sand in the bladder are particles that vary in color, size, shape, density and composition.

Particles measuring 1–3 millimeters are considered small. They are called "sand". Medium - from 4 to 9 mm, large - from 10 mm or more.

The shape can be round, oval, triangular, prickly, with uneven edges, or needle-shaped.

The density and color of urinary stones depend on the organic acids and minerals from which they are composed. Find out what they are in chemical composition and how to distinguish them. Stones are:

• Oxalate (consist of a calcium compound and oxaloacetic acid). Have high density, black or dark brown color, different shapes. Uneven stones pass with pain through the urethra;
• Urates (they are made up of salts uric acid). Low density, round or oval, red in color;
• Phosphate (from calcium and phosphoric acid). They have a soft structure, different shapes, and a rough surface. Gray color. Grow and dissolve quickly;
• Cystine (consist of the amino acid cystine and its compounds with minerals). Round in shape, with a smooth surface, white or yellow, not hard;
• Struvite (from ammonium, magnesium, calcium salts). They appear as a result of the activity of certain bacteria that inhabit the kidneys. Soft, white-yellow or gray, give scanty symptoms.

Are there any different types stones in one patient? Undoubtedly! More than half of patients with urolithiasis have mixed composition stones. The nature of movement along the urethra depends on their shape and size.

Diagnostics

If you suspect the presence of stones in the kidneys or bladder, you should consult a urologist. After the conversation and initial examination, the specialist can determine preliminary diagnosis and schedule an examination:

• General blood and urine analysis. (Urine tests will reveal blood cells and inflammatory cells– leukocytes, sometimes – protein, bacteria, salts);
• Creatinine, serum urea. Will help to draw a conclusion about the functioning of the kidneys;
• Ultrasound of the kidneys (if a stone has fallen into the bladder from the kidneys, it is necessary to find out how many of them are left there);
• Ultrasound of the bladder with determination of the amount of residual urine. The organ is examined in a lying position, standing, on its side;
• TRUS (transrectal sensor evaluates the prostate gland);
• Observatory, excretory urography with a descending cystogram (x-ray with contrast agent);
• Cystourethrography – photographs with the introduction of contrast into the bladder through the urethra;
• Cystoscopy (an optical device - a cystoscope is inserted into the bladder through the urethra);
• CT scan. One of the most informative studies. Allows you to make a diagnosis with 100% accuracy and shows the density of stones.

Treatment

Treatment of bladder stones is surgical. Surgery is not performed on small stones, in severely ill patients with renal failure or other pathologies, in immobile patients, or in very elderly patients. In these patients, attempts can be made to dissolve bladder stones with medication, but this is rarely effective.

Treatment of bladder stones in men always involves eliminating the cause of bladder outlet obstruction. Otherwise, repeated stone formation cannot be avoided. That is, the prostate adenoma will definitely be removed, the urethral stricture will be excised, the diverticulum will be removed, and the foreign body will be removed.

Patients who cannot be operated on are advised to take drugs that dissolve stones (nephradoz, rovatinex, prolit, urolesan). Sometimes it is possible to dissolve large stones, especially if they are urates or phosphates.

The stone can be removed using cystolithotripsy - crushing. It is used if the stone is located in the cavity of the bladder or at the mouth of the ureter. For bladder stones, the contact method of crushing stones, that is, ultrasonic grinding, is more often used. Using this method, it is possible for men and women to crush the stone into small fragments, which will be excreted independently in the urine under the influence of medications in the postoperative period.

Patients wonder if crushing a stone hurts? No. This manipulation is performed under spinal anesthesia.

Other stone removal operations:

• Laser crushing. The most optimal, as it allows you to destroy dense stones and shortens the recovery period after surgery
• Using DLT (external lithotripsy, when the calculus is broken by a shock wave of air through the skin). Most often used for kidney disease.
• Open surgery. The entire stone is removed, and the bladder is sutured with absorbable sutures. You will have to walk around with a urinary catheter for 7-10 days after the operation.
• Cystolitholapaxy - removal with an instrument through the urethra during cystoscopy or through a vesical fistula on the anterior abdominal wall. Removing stones from the bladder in women is easier, since the urethra in women is shorter and wider, which makes it easy to insert an instrument.

The postoperative period after crushing is easier, since there are no incisions on the body or on the organ itself. While in the hospital for the first days after surgery, a person may excrete small fragments of crushed stones in the urine; how many of them will be released is not known in advance. Doctors know how to speed up the passage of a stone or its fragments after lithotripsy. Conservative therapy is prescribed:

• For better removal of small grains of sand: canephron, rovatinex, blemarene, spilled
• To relax the urethra and urinary cervix in men, adrenergic blockers are prescribed, making the lumen of the urethra wider, which helps remove fragments: Omnic, Urorek, Focusin, Dalfaz
• Antibiotics and antispasmodics are required.

Taking tablets that affect the chemical composition of stones along with surgical treatment leads to complete recovery.

Urinary disorders that occur after the operation are relieved after a month. To treat hematuria, hemostatic injections or tablets are used.

How to remove a stone from the bladder is known traditional medicine. Traditional methods of getting rid of stones involve taking herbs (knotweed, bear ear, lingonberry leaf, currant, dill seed, orthosiphon, half-palm, goldenrod, madder, hop cones, Birch buds, corn silk). 4-5 herbs are taken in equal proportions and mixed. 1 or 2 tablespoons of the mixture are poured with boiling water, infused for an hour and drunk in several doses a day. This way you can expel the stone and completely get rid of the symptoms of the disease.

After a few weeks of taking herbal infusions, a person will feel that a stone has passed. What to do? The main thing is not to throw it away, but to take it to the laboratory for analysis of its chemical components. Subsequently, it will be possible to take medications to prevent the disease.

Possible complications

It is necessary to treat a person with bladder stones, even the symptoms of the disease are mild. Complications that a stone can lead to:

• Acute urinary retention. If the stone blocks the lumen of the urethra, the patient will not be able to urinate on his own. You will have to go by ambulance to the hospital;
• Acute and chronic cystitis - inflammation of the mucous membrane of the bladder;
• Pyelonephritis (kidney inflammation). Exacerbation of the process is characterized by a rise in body temperature, lumbar pain, and weakness. Requires hospitalization;
• Excretion of blood in the urine – hematuria. Serious blood loss with a decrease in hemoglobin is possible with heavy bleeding from the bladder cavity;
• Ureterohydronephrosis is dilation of the ureters and kidneys due to the accumulation of urine in the upper urinary tract. The bladder stone gradually grows, sometimes reaching huge size, partially blocks the exit of urine from the mouths of the ureters, the openings through which urine from the kidneys flows into the bladder. These small slit-like openings (ostia) are located in the bottom of the organ close to the confluence of the urethra;
• Complications after crushing are also possible: these are exacerbations of inflammatory processes, hematuria, perforation of the bladder wall with an instrument.

Prevention

Prevention of bladder stones includes the following measures:

• Diet. The diet depends on the composition of urinary stones. It is necessary to limit the consumption of such foods as spices, spicy and bitter dishes, concentrated broths, coffee, chocolate, mushrooms, legumes, sweet soda, large amounts of greens (sorrel, spinach), alcoholic drinks;
• Eating foods that help break up stones: apples, apricots, pumpkin, cucumbers, melons, bananas, cauliflower, carrots, zucchini;
• Men's diet should include low-fat varieties meat, nuts (except peanuts), no more than one egg per day. Protein, necessary for men those engaged in physical labor, at the rate of 1.5 g per 1 kg of weight;
• Drink 1.5 - 2 liters of clean water per day;
• Accept quarterly urological fees(bearberry, pol-pal, orthosiphon, corn silk) in a course of 2-3 weeks for the prevention of cystitis;
• The main thing is to find out the cause of urolithiasis and eliminate it;
• Undergo an ultrasound examination every six months;
• In case of kidney urolithiasis, you should take drugs to dissolve them (nephradose, prolit, hydrangea and others);
• Timely change urinary catheters, cystostomy drainages, stents. Proper care is required if they are present;
• Sport. Moderate exercise, running and walking help prevent stone formation.

Urolithiasis is quite widespread throughout the world. It accounts for more than a third of all diseases of the urinary system.

Despite the fact that it has been well studied, the mechanism of stone formation is known, the number of cases of morbidity not only has not decreased, but, on the contrary, is steadily increasing.

The reason for this, according to most doctors, may be deterioration ecological situation, an increase in the population’s tendency to physical inactivity and improper, including excessive, nutrition.

What it is?

Urolithiasis is the presence of insoluble stones (calculi) in the urinary tract and in the kidneys themselves. The disease occurs more often in men, but the risk of the disease is also observed in obese women.

Causes and mechanism of development

The process of stone formation is influenced by a number of factors, the main of which are:

The root cause of the appearance of stones in the bladder is important aspect. Before removing stones, doctors will often prescribe a course of therapy that eliminates the cause of the pathology (for example, they treat metabolic disorders, eliminate infectious diseases).

Classifications

The stones may be various forms and shades, consistency and chemical composition, and also have a multiple or single character. Small stones are called microliths, large stones are called macroliths, single stones are called solitary stones. There are several classifications and forms of the disease.

According to the types of stones, pathologies can be of the following forms:

In addition, stones can be primary or secondary in nature. During primary formation, stone formation occurs against the background of stagnation of urine in the bladder cavity. In the secondary form of the disease, stones form in the kidneys, and they enter the bladder cavity through the ureter.

Symptoms of the presence of stones

In women, the symptoms of bladder stones are varied, but they cannot be called characteristic only of this disease. If the stone moves into the bladder and has not yet descended into it, then signs of the disease manifest themselves in pain different strengths. This can be pain in the lower abdomen in the suprapubic region; in men, the pain can radiate to the perineum and penis. It intensifies when urinating, when changing body position.

If the stone has formed in the bladder itself or has already safely descended into it through the ureter, then the symptoms will be different. The pain is mild and intensifies when urinating or during sexual intercourse. The presence of a stone can be determined when it blocks the urethral opening. Its sign may be an interruption of the urine stream or its complete blocking.

Acute urinary retention may be replaced by incontinence if the internal sphincter of the bladder does not close due to a stone blocking it.

Diagnostics

With stones in the bladder, symptoms can be detected in varying degrees however, in any case, they are grounds for a visit to the doctor. During the diagnosis, this assumption will be confirmed or refuted. Necessary research will allow you to determine not only the presence of a stone, but also its exact location, size, nature of the stone-forming substance, as well as the presence/absence concomitant diseases etc.

As a rule, in this case the following is carried out:

• general analysis urine;
• general blood analysis;
• urine test for stone-forming function;
• X-ray examination;
• Ultrasound, etc.

If there are grounds to suspect the presence of other diseases, treatment may be prescribed. additional research and diagnostic measures, which ones exactly, in each special case determined by the attending physician. After receiving comprehensive information regarding this disease, the patient is prescribed adequate treatment, in particular, it is determined exactly how the stone will be removed.

Possible complications

Even if a stone in the bladder does not cause any painful symptoms in the patient, which is not at all a rare situation, it is necessary to remove it due to possible complications. First of all, the patient is susceptible to blocking the outflow of urine at any time, developing hydronephrosis or pyonephrosis, and even kidney damage.

Frequent inflammation of the urinary tract can lead to progressive kidney dysfunction and the development of arterial hypertension. The presence of stones within the bladder can cause:

• constant irritation of its wall;
• the formation of abnormal structures, as well as cancer cells;
• a violation of the contractility of the muscles of the bladder with the occurrence of so-called atony or, conversely, its excessive contractility.

The necessary treatment should be carried out immediately after confirmation of the diagnosis. You should not delay the operation, as this can lead to necrosis of the kidneys and ultimately to renal failure.

How do bladder stones break up?

Depending on the severity of the symptoms, one of the treatment options for bladder stones is selected:

1. Removing stones using a cystoscope. In this case, a special metal tube equipped with optics is inserted into the patient's urethra. The bladder and ureteral orifices are examined. Then a tube, a stent, is inserted into the opening of the ureter, where the pathology is found, which resumes the natural outflow of urine.
2. Conservative treatment. It is prescribed when the size of the stones is less than 3 millimeters. In this case, the patient is offered therapy medicines And therapeutic nutrition. The main goal drug treatment is to dissolve stones and eliminate acute attack diseases. To combat pain, drugs such as No-shpa, Baralgin, Papaverine, Spazmalgon are prescribed. Medicines are presented in wide range at any pharmacy. The drugs act on the walls of the ureter, relaxing it and thereby activating the mobility of the stone. However, antispasmodics can only eliminate pain, but cannot relieve the patient from the main cause of the disease - the stone.
3. Surgical intervention. This is the most radical method treatment of urolithiasis. Surgery is necessary when the stone grows to a large size. As for the incision, it is performed in the place where the stone is diagnosed. After removing the stone, specialists drain the area to remove urine that leaks through the bladder wall.

In addition, the procedure for crushing stones - remote wave lithotripsy - is also considered an operative method of treatment. During the manipulation process, the stones are crushed and then removed.

Patient recovery period

For five days after the stones pass, the patient is in the hospital and takes antibacterial drugs, doctors perform periodic catheterization of the bladder. After 21 days, the patient is strictly monitored using ultrasound of the organ and metabolic monitoring.

When the doctor removes stones through surgical intervention, the patient sometimes experiences the following complications:

• tamponade and hemorrhage in the bladder;
• postoperative infection;
• damage to the walls of the organ.

Folk remedies and recipes

Natural drugs do an excellent job of removing various salt formations from the urinary tract of the stronger sex. Pledge successful treatment – regular use folk remedies, their proper preparation.

1. Sunflower roots. First, rinse the raw materials thoroughly, chop finely, pour into a saucepan, pour three liters of boiling water, cook for five minutes. There are enough raw materials to prepare three servings of the decoction; drink the strained decoction half a glass three times a day for one month.
2. Onion tincture. Fill half a jar with onion, cut into rings. Fill the vegetable to the top with alcohol or vodka, let it brew for ten days. Take the resulting product two tablespoons twice before meals. The duration of therapy depends on the size of the formations in the bladder.
3. Vegetable juice. Drink 100 grams of carrot/cucumber/beetroot juice three times a day. You can prepare a mixture of juices and drink them twice a day. The course of therapy lasts no more than two weeks; prolonged treatment can lead to the development of an allergy to the selected components of the drug.
4. Tangerine therapy. The method is allowed for patients who are not prone to allergies. Eat up to two kilograms of tangerine throughout the week. Take a week break and repeat the treatment procedures.

Before starting therapy, consult your doctor if you experience allergic reactions, choose another traditional medicine recipe.

Nutrition and diet

Regardless of the location of the stones in the body, doctors prescribe therapeutic nutrition to patients - the so-called table No. 7.

The main principles of such nutrition include the following points:

• for oxalate formations, limit chocolate, meat, nuts, strong coffee and tea drink;
• if calcium compounds are diagnosed, limit or eliminate salt;
• when cystine stones are detected, reduce consumption of animal proteins;
• If struvite forms, protect yourself from urinary system infections, and if they occur, treat them promptly.

Prevention

Since the etiology of urolithiasis is multifactorial, prevention should be the same. First of all, you need to adjust your diet. To prevent urolithiasis, it is necessary to exclude or limit fatty foods, smoked meats, pickles, spices and other products containing large amounts of fat and salt.

It is also necessary to remember the correct water regime. It is considered normal if a person drinks about one and a half liters of liquid per day and goes to the toilet about six to ten times. If your personal performance falls outside this standard, you need to think about your own water-salt regime.

It is also necessary to take into account the fact that people in sedentary professions suffer from urolithiasis much more often than active workers. Thus, sport can become another means of preventing urolithiasis.

Conclusion

At the first symptoms of the disease, you must consult a doctor for diagnosis and initiation of treatment. With strong pain syndrome you need to call an ambulance, since such pain rarely goes away on its own, and the patient needs urgent provision help.

A problem that often requires surgical intervention, is urolithiasis. Bladder stones, the symptoms of which do not appear immediately, most often bother males. The size, chemical composition and type of stones may vary.

Where do they come from?

Sand in the bladder can move from the kidneys. The same goes for stones. This variety is also called secondary. Stones can also be primary, that is, they arise directly in the bladder. The causes of the disease can be:

• pathological conditions leading to disruption of normal urination: fluid is retained, which contributes to the appearance of salt crystals and then stones;
• consequences of surgical intervention;
• disturbance of innervation;
• congenital and acquired bladder defects;
• neoplasms, foreign bodies;
• schistosomiasis;
• inflammatory processes;
• prolapse of the bladder along with the uterus in women.

Symptoms

As mentioned above, even if stones have formed in the bladder, symptoms do not appear immediately. Stones can be identified using special medical equipment. The most commonly reported symptoms of bladder stones are:

Diagnostics

Only with the help of certain examination methods can stones in the bladder be detected. The patient’s symptoms and complaints are important for establishing a diagnosis, but a general urine test (erythrocytes and leukocytes in this case are increased), bacteriological culture (helps to establish the presence/absence of bacteria), as well as the results of ultrasound (usually using it) are also taken into account even small pebbles can be detected, as well as their location). Detailed information the disease can be obtained through urethrocystoscopy. This instrumental method It also allows you to assess the condition of the bladder mucosa. Other research methods that help identify stones in the bladder (symptoms, we repeat, do not appear in all cases) include excretory urography, radiography, and computed tomography.

Treatment

Bladder stones can be removed using the following methods:

1. Stone crushing.
2. Lithotomy.

The first involves inserting a special instrument into the bladder for crushing. These can be electrohydraulic, ultrasonic or pneumatic lithotripters. After crushing the stone, its particles are removed. Stone cutting already presupposes surgery. Through abdominal cavity stones are rarely removed; a suprapubic extra-abdominal incision predominates. If the stones are very small, doctors suggest the patient drink a large amount of liquid so that the stones pass on their own.

Bladder stones (cystolithiasis) are one of the types of urolithiasis, characterized by the presence of calcified or saline stones in the organ cavity. Mineral hard formations inside the bladder are most often observed in older men. They are also found in women, and sometimes in preschool children.

General information about bladder stones

Acids and salts (urates, phosphates and oxalates) are found dissolved in the urine of any healthy person. Normally, their quantity is insignificant, but when favorable conditions for the occurrence of urolithiasis appear, the concentration of these substances increases and they begin to crystallize, forming stones. First, small grains of sand appear in the bladder - so-called microliths (up to 3 mm in diameter). Gradually, accumulating, they connect with each other and turn into macrolites (the size of a duck egg).

Formation process urinary stone can last for years.

The occurrence of the disease is promoted by:

• disturbances in the body's water-salt metabolism;
• change acid-base balance arising from infectious diseases and intoxications;
• sedentary work;
• frequent experiences and neuropsychic disorders;
• abuse of alcohol, smoking and certain medications.

The formation of stones is favored by factors that make it difficult for urine to exit the bladder. These include:

• swelling or narrowing (stricture) of the urethra;
• hyperplasia (enlargement) of the prostate gland;
• phimosis (narrowing of the foreskin);
• bladder atony;
• narrowing of the external entrance to the urethra;
• diverticula of the bladder (bag-like protrusions of its walls);
• tumors or foreign bodies inside an organ.

The incidence in men is caused by the fact that urinary stagnation often occurs due to benign growth (hyperplasia) or sclerosis of the prostate, as well as urethral stricture. In women, cystolithiasis is quite rare.

Types and origin of bladder stones

Stones are classified according to their origin:

• primary, formed in the bladder initially due to stagnation of urine, stones of this type are found mainly in men;
• secondary, formed in the kidney and later descending through the ureter into the cavity of the bladder, that is, being a consequence of urolithiasis in the upper urinary tract.

Due to the slower passage of urine in the vesicourethral segment, it gradually becomes thicker. A precipitate begins to form in the bubble, and then these salt or acid elements combine together and form conglomerates. Rocks can also grow around foreign objects: rubber, metal and glass parts of instruments accidentally left in the organ during medical procedures, or bone fragments that fell into the bladder after a complex fracture of the pelvis.

There are also stones called ligature, formed from suture material. In case of injuries or operations on the bladder, as a rule, self-absorbing catgut sutures are applied, since salts are deposited on stitches made of any other material, eventually forming a calculus. Stones of ligature origin grow when, for some reason, during urological or gynecological operations, material that does not dissolve was used for sutures. This is practically the only reason why stones of the primary type are formed in women; in addition, prolapse of the bladder (cystocele) also predisposes to the formation of stones.

Stones can form after surgery for urinary incontinence, when the neck of the organ is attached to the pubic symphysis and the entire thickness of the bladder wall is mistakenly captured in the suture.

According to their chemical composition, formations are:

• oxalate, consisting of oxalic acid lime and having a brownish-brown color and a spiky surface;
• phosphate, formed by crystals of calcium phosphate, white in color with a smooth surface;
• urate, consisting of particles of uric acid, colored yellow having a flat shape or similar to an egg;
• mixed - solid conglomerates created from several types of salts or acids with a layered texture.

Concretions are found single and numerous, and their number ranges from 1 to 100 pieces. They can have any shape, but are usually represented by round formations with a smooth surface ranging in size from 0.3 to 7 cm in diameter. But there are also rough stones with long processes.

Table: types and composition of bladder stones

Photo gallery: types of stones in the bladder

Larger urate stones form from individual small granules Multiple irregularly shaped phosphates often form in the background chronic cystitis Oxalates are usually single stones Phosphates big size can form huge conglomerates in the bladder, which minimally invasive methods it is quite difficult to eliminate Urate stones are often formed during inflammation and hyperemia of the bladder mucosa Large phosphates are often formed during inflammation of the bladder with elements of hemorrhage One large stone of a mixed type can be crushed inside the bladder into several smaller stones

Clinical picture of the disease

Clinical symptoms of the presence of stones in the bladder are quite uniform and typical. Stones cause pain in the lower abdomen and above the pubis, which intensifies with physical stress and patient movements. At the same time the person feels frequent urge to urination. The pain in men radiates to the penis and groin, in women - to the perineum and thighs.

But sometimes even large stones do not make themselves felt and do not bother the patient. The patient begins to feel discomfort when urination is impaired, constant friction of the rough stone against the walls of the bladder, irritation and inflammation of the inner surface of the latter. If a stone gets into the neck of the organ and prevents the internal sphincter from closing, urinary incontinence develops.

Pain occurs due to the traumatic effect of the stone on the mucous membrane of the bladder, its inflammation or compression of the nerve endings by the stone. These sensations are especially strong when a stone is pinched in the urethra. In this case, acute urinary retention is observed: a person tries to empty the bladder, but when straining, only a few drops are released, and an intermittent stream is also characteristic. Urination is restored only when the body position is changed. Having realized this, the patient begins to look for suitable posture: lies on the side, on the back, men urinate like women - squatting. After the strangulation is eliminated, blood appears in the urine. Subjective discomfort stop only at night, in a calm state.

If cystitis occurs, the course of the disease and the person’s well-being worsen. Urination becomes frequent and painful, especially at the end of the act, and the patient is forced to visit the toilet several times a night. This condition is characterized by high leukocytosis, a large number of bacteria and a noticeable admixture of blood and pus in the urine. A complication of cystitis that occurs due to urolithiasis in the bladder can be pyelonephritis.

Video: bladder stone

Diagnostics

Detection of stones in the bladder usually does not cause difficulties for an experienced urologist. Diagnosis is based on clinical symptoms, as well as on the results of cystoscopy, ultrasound and X-ray excretory urography.

Diagnostic cystoscopy involves examining the bladder from the inside using a special device inserted through the urethra - a cystoscope. During the procedure, one or more stones are identified. The appearance and color of the formations can suggest their chemical composition.

In the case when the presence of stones is accompanied by cystitis, corresponding changes are visible on the mucous membrane lining the bladder: its redness (hyperemia), swelling. If a diverticulum is present, the entrance to the pocket is determined. Cystoscopy is especially informative when detecting urates - stones of this type do not give a visible shadow on x-rays.

X-ray methods

If the presence of stones in the bladder is suspected, the patient is offered ascending (retrograde) X-ray examination- cystography. A series of images is taken after the organ is filled with a contrast agent from the bottom up, using a catheter inserted through the urethra. After the examination is completed, the bladder is emptied. This method allows you to determine the size, number and shape of stones, their placement in the diverticulum. In the latter case, a small shadow is visible on the urogram slightly to the side of the border of the bladder.

If it is impossible to insert a catheter into the organ (when the patient has a urethral stricture, tumor occlusion of the lumen of the bladder neck, acute urethritis, etc.), descending (antegrade) cystography is performed. A contrast agent is injected into the patient's vein, which travels through the bloodstream to the kidneys. 45–50 minutes after the injection, the colored biological fluid appears in the bladder. At this time, photographs of the organ are taken in the anteroposterior, axial and semi-lateral positions. With an antegrade study, they turn out to be somewhat less clear than with an ascending study. Together with excretory intravenous urography, cystographic examination is the most informative and popular method for diagnosing urinary tract diseases.

Another type of this method is pneumocystography, when contrast agent the bladder fills with oxygen. Gas is administered not only through the urethral catheter, but, if necessary, using suprapubic drainage of the organ or by puncture.

Ultrasound in the diagnosis of cystolithiasis

In the case when the patient is contraindicated for the insertion of a catheter or cystoscope, as well as when there are urates in the bladder that are invisible to x-rays - stones composed of uric acid crystals, ultrasound comes to the rescue. Ultrasound is used to diagnose cystolithiasis in young children, for whom cystoscopy can only be performed under anesthesia, and in elderly patients with benign prostate enlargement. Inserting an instrument into the urinary organs of such patients can cause them to develop acute pyelonephritis.

On an echogram, a calculus with a bladder filled with urine is visualized as an echo-positive formation with clear contours.

Video: bladder stone on the ultrasound machine screen

Differential diagnosis

Bladder stones are differentiated from pathologies that have similar symptoms:

• cystitis;
• urethral strictures;
• prostate tumors.

Indicates the presence of a stone specific symptom– “blocking” of the urinary stream, when during the act of urination there is a sudden cessation of the secretion of this biological fluid. Other distinctive signs of cystolithiasis:

• spraying a stream of urine in different directions;
• increased pain in the suprapubic region when moving and lifting heavy objects;
• the appearance of blood in the urine after any physical activity.

How to remove stones from the bladder

With a small diameter (up to 0.5 cm), stones are sometimes washed out with copious and intense urination without any action on the part of the patient. More chances for independent exit have stones of a secondary type, that is, descended into the bladder through the ureters from the kidneys.

But more often you have to resort to medical manipulations and various means to get rid of stones. It should be remembered that even if it was possible to remove them from the bladder, this does not relieve the patient of urolithiasis. As long as anatomical or physicochemical conditions favorable for the formation of stones exist in the body, a relapse of this pathology can occur at any time.

Medicines

To prevent the formation of new stones and the growth of existing stones, in the absence of contraindications, the patient is prescribed drugs that prevent the formation and promote the dissolution of stones (Rovatinex, Uralit-U, Fitolysin) and vitamin C to acidify urine. If cystitis is complicated, therapy with antibiotics and uroseptics is recommended (including, for example, Furamag, Palin, 5-NOK) along with plenty of fluids.

To prevent urine from stagnating in the bladder, causing an increase in existing stones, the patient may be prescribed diuretics (diuretics), for example, Furosemide. Sometimes there is a need for analgesics: to relieve painful spasms The patient is recommended Papaverine, Baralgin, Spazgan.

Photo gallery: drugs for the treatment of urolithiasis

Spazgan will relieve pain and spasms Phytolysin - herbal preparation Furomemide, which has an anti-inflammatory effect, will help flush out small stones from the bladder

Folk remedies

Traditional medicines can occupy a worthy place in the complex of therapeutic measures and be used as natural diuretics and uroseptics that prevent the development of infection in the bladder. Diuretics can only help expel stones when they are in the form of sand or microlites. With a large stone, they, alas, are powerless. But if herbal remedies do not completely eliminate this disease, they at least alleviate the suffering of the patient. Before using any product, you should consult your doctor.

In order to cook healing drink from cranberries, you need:

1. Pour 2 cups of fresh ripe berries and crush them with a special puree spoon to form juice.
2. Transfer the resulting pulp into a vessel with boiling water (1 l).
3. Cover with a lid, turn off the heat and let sit for 15 minutes.
4. Strain the infusion through a fine sieve.
5. Crush the berries remaining in the sieve so that they release all their juice.
6. Pour the product back into the vessel, put on low heat, add sugar to taste, stir and bring to a boil.
7. With the drink boiling, turn off the heat and let it sit for 1-2 hours.

Cranberry juice- a storehouse of vitamins and excellent antiseptic for the bladder.

Knotweed infusion

An infusion of knotweed, a herb that grows everywhere, perfectly counteracts stone formation in the lower urinary tract. To prepare the product you need:

1. 2 tbsp. l. plants, pour 0.5 liters of boiling water.
2. Place on water bath and heat for 10 minutes.
3. After this, let it brew for 1 hour.
4. Strain and add boiling water to the drink so that the liquid volume becomes 0.5 liters.

Drink 0.5 glasses three times a day before meals.

Juice mixture against urinary stones

It will be useful to mix the juice of two lemons with a glass of warm water and drink several times throughout the day. At the same time, you need to take a third of a glass of a mixture of carrot, cucumber, tomato and beet juice 5-6 times a day for a week or two, until the sand is completely released from the bladder.

Decoction of rosehip seeds

For stones in the bladder, a decoction of rosehip seeds will be useful. To prepare it you should:

1. Pour 0.5 liters of boiling water 1 tbsp. l. rosehip seeds.
2. Boil over low heat for 15 minutes.
3. Let cool, strain.

You need to take the resulting decoction ¼ cup three times a day before meals.

Medicinal infusion

You need to prepare an equal amount:

• adonis herbs;
• rose hips;
• juniper fruits;
• steelhead roots.

You need to pour 4 tbsp. l. collect 1 liter of boiling water, let stand for 3 hours, then strain. The product should be drunk in small portions throughout the day.

Rice breakfasts

To remove sand and sand from the bladder small stones You can try the traditional method of rice breakfasts. How to do it:

1. Prepare 5 clean glass jars of 0.5 liters each.
2. Pour 2 tbsp into the first jar. l. dry rice, cover with cold water and let stand for 24 hours.
3. On the second day, drain the water, rinse the rice, fill it with new water in the same jar and leave it to soak for 5 days.
4. At the same time, pour another 2 tbsp into the second jar. l. rice and also add water.
5. The next day, rinse the rice from the second jar, add fresh water again and leave for 5 days.
6. Do the same with the other three banks.
7. After 5 days, all 5 jars will be filled with rice, and in the first one it will be ready.
8. Boil the rice from the first jar without salt and eat it without oil in the morning for breakfast. Do not drink or eat anything for the next 4 hours.
9. Pour 2 tbsp into the empty first jar again. l. rice and add water. Then repeat these steps every day.

You need to eat this rice for breakfast for at least two months.

Decoction of cornflower and horsetail

The decoction is prepared as follows:

1. Mix an equal amount of cornflower flowers and horsetail grass.
2. Pour boiling water over the raw materials at the rate of 2 cups of water per 2 tbsp. l. plants.
3. Cook for 15 minutes.
4. The broth is filtered.

It should be drunk hot in small sips; it acts as a diuretic. While drinking, you can massage your lower abdomen in the area of ​​the bladder, and then lie down and apply it to problem area a poultice filled with hot boiled horsetail herb.

Diet food

The diet for a patient with bladder stones does not play such an important role as for kidney stones, but still some rules should be followed. The diet of a patient with cystolithiasis should be adjusted in such a way as to normalize water-salt metabolism in organism. To do this, you need to limit your consumption of table salt and generally reduce your daily diet.

If you have urates, you should avoid the following foods:

• broths;
• chocolate;
• cocoa;
• coffee;
• liver;
• kidney;
• fried and spicy foods.

For oxalate stones, a diet low in oxalic acid is needed. It is necessary to limit in the diet:

• tomatoes;
• sorrel;
• spinach;
• green salad;
• potato;
• carrot;
• dairy products;
• oranges and grapefruits;
• chocolate;
• meat broths;
• fats;
• meat of young animals.

If the stones have a phosphate composition, then the patient needs nutrition that promotes the oxidation of urine. To do this, you need to diversify your menu with fish, meat, flour products, lard, and vegetable fats.

To prevent the formation of new stones, it is necessary to reduce the concentration of urine; for this it is important to adhere to the correct drinking regime. It is recommended to drink as much fluid as possible, and preferably mineral water. For uric acid stones, the patient is prescribed Borjomi, Essentuki and others. For phosphates and oxalates - “Izhevsky Spring” or “Narzan”. The patient should drink at least 2–2.5 liters of mineral water per day.

Surgical intervention

The most effective treatment is surgical removal bladder stones. Modern gentle techniques allow the intervention to be performed even on elderly patients who have suffered such complications in the near past. serious illnesses, like myocardial infarction and others. In most cases, stone removal procedure (lithotripsy) is performed endoscopically - as patients say, “without cuts and blood.” In other words, access to the surgical field is through the urethra. Transurethral extraction (extraction through the urethra) of a single small stone in its entirety is possible.

Both with open and endoscopic destruction and removal of stones, spinal anesthesia is used, during which the sensitivity of the lower half of the patient’s body is turned off for several hours.

Contraindications to all types of endoscopic lithotripsy:

• acute cystitis;
• urethritis;
• prostatitis;
• small bladder capacity;
• obstruction of the urethra and the inability to insert a cystoscope into the bladder;
• age up to 6 years.

After endoscopic crushing and removal of stones in the patient’s bladder, a catheter is left in place for 24 hours to drain urine. After removing the instrument, the patient spends another 4–5 days in the hospital under the supervision of doctors, then he is sent home.

Contact pneumatic lithotripsy

A special instrument (operational cystoscope) is passed through the urethra into the bladder. First, the stone is destroyed and its grains are washed away, and then in the same way endoscopic method the patient is relieved of prostatic hyperplasia, which in most cases causes a violation of the outflow of urine.

During contact crushing of a calculus, the latter is destroyed by the tool into several small fragments. Lithotripsy occurs in a gas environment. These fragments are then washed out of the bladder using the same cystoscope.

The working surgical instrument is so thin and delicate that all the action takes place inside the organ cavity, maintaining its integrity and without disturbing the structure.

Video: endoscopic contact crushing of a stone in the bladder

Laser crushing

Laser surgical aid allows you to crush the calculus into even thinner and smaller fragments than the previous method. To completely rid the patient of stones, one procedure is sufficient. In this case, a flexible cystoscope is used, inserted into the organ through the patient’s urethra, which is equipped with a special laser beam. The latter turns solid conglomerates almost into dust, after which they easily leave the bladder with a stream of urine.

The intervention is absolutely painless for the patient, while he sees and hears everything that is happening and even has the opportunity to watch the progress of his operation on a special video monitor.

Open abdominal surgery

If it is impossible to perform fragmentation and removal of stones using the transurethral method, it is necessary to resort to open surgery with cutting the bladder (cystotomy). Such intervention is carried out in the following order:

1. The patient lies on his back with his pelvis slightly elevated.
2. In the center of the lower abdomen, along a line running from the pubis to the navel, an incision 9–11 cm long is made, cutting through the skin and its base.
3. Muscles abdominals spread to the sides, opening the prevesical tissue.
4. By pushing the fold of peritoneum upward, access to the bladder is opened.
5. Two holders are placed on the front wall of the organ and it is cut lengthwise or crosswise between them.
6. Using an instrument, the stone is removed; if there is a diverticulum, then that is also removed.
7. The incisions on the bladder and abdominal wall are sutured in layers.
8. A catheter is inserted into the bladder and left for several days.

In the postoperative period, provide constant irrigation of the bladder with antiseptic solutions. If there is an obstacle to urination and a strong inflammatory process in the organ, leave a polyethylene drainage tube, which, if the healing process is favorable, is removed on days 7–11.

Video: extraction of oxalate from the bladder using cystotomy

Rehabilitation in the postoperative period

It should be remembered that the recovery period after surgery lasts about two months. Even if no incisions were made during the intervention, the inner surface of the bladder is a fairly extensive wound.

Restoration of the mucous membrane occurs within 1–1.5 months. Throughout this period, the patient takes prescribed anti-inflammatory drugs, which prevent the development of infection and speed up the healing process. Water load is recommended: the amount of pure or mineral water drunk in the postoperative period should not be less than 2 liters per day.

Consequences, complications and prognosis of treatment

With absence timely treatment the development of the disease continues. The size of the stones and their number increase, and infection occurs. First, chronic inflammation of the bladder (cystitis) develops, followed by pyelonephritis - inflammation renal pelvis and cups. In the future, all this can lead to chronic renal failure, which is often fatal.

Timely treatment allows the patient to return to normal life, completely restore natural bladder emptying and get rid of pain. In the future, he needs regular monitoring by a urologist and an ultrasound examination of the urinary organs twice a year.

If the causes that led to stone formation in the bladder are eliminated, the prognosis is good. However, with ongoing disorders in the body that caused urolithiasis, sand and stones may reappear.

Prevention

Every man over 50 years of age must mandatory be examined by a urologist at least once a year. By preventing problems with the prostate gland, the formation of stones in the bladder can be avoided.

An excellent remedy for preventing the appearance of stones in the urinary organs is strong green tea. You need to drink it without sugar, and at least four glasses a day.

Of great importance for the prevention of stone formation is the fight against urinary tract infections and urodynamic disorders, as well as diseases of the endocrine system. When working sedentarily, you need to get up every hour and do a warm-up to prevent stagnation in the small pelvis.

The topic of anatomy, physiology and human health is interesting, loved and well studied by me since childhood. In my work I use information from medical literature, written by professors. I have my own behind me great experience treatment and care for patients.