Antibiotics for urolithiasis in men. Medicine for kidney stones

Urolithiasis of the kidneys is a metabolic abnormality in which the formation of so-called calculi occurs in the kidneys. Nephrolithiasis is quite common, difficult to identify without the help of a doctor, and almost never goes away on its own. Various methods of therapy are used for treatment, including medication and physiotherapy. The doctor, based on the test results, prescribes a medicine for urolithiasis kidney; antibiotics, which can also be prescribed, although they are not included in the list of treating drugs, relieve bacterial infection, which may be accompanied by nephrolithiasis.

Medicines for urolithiasis of the kidneys belong to conservative methods of therapy and should be focused on the following functions:

destruction of stones, their crushing into smaller fractions, or complete dissolution with subsequent removal from the body in urine.
correction of the body's metabolic process. Without normalization of metabolism, treatment cannot be considered successful, since without eliminating the root cause of stone formation, the disease will recur again and again;
strengthening the immune system. Without a strong immune system that responds correctly to infections and ignores temporary disturbances in organs, nephrolithiasis can provoke autoimmune processes;
elimination of inflammation. Often stones cause inflammatory processes in the kidneys and urinary tract;
improvement of organ hemodynamics. The presence of tumors in the kidneys means a violation of blood circulation in these organs.

Depending on the chemical composition of the tumors, drugs are selected that have a targeted effect on them. In total, science knows four types of chemical composition:

oxalates - derivatives of oxalic acid (its salts)
phosphates - calcium phosphate (apatite)
struvite - ammonium phosphate
carbonates - carbonic acid (calcium salts)
urates - uric acid (salts)
organic compounds - protein stones, cholesterol, amino acids.

The following drugs are used:

progesterone. Expands the lumen of the ureters and reduces the tone of muscle tissue to facilitate the removal of stones
glucagon. A relaxant of the smooth muscle tissue of the walls of the urinary tract. Blocks strong muscle contractions
amlodipine, nifedipine. Used to block calcium channels, eliminate spasmodic syndrome, improve the movement of tumors along the ducts
prednisolone. Glucocorticosteroid necessary for the correct “work” of blockers
alpha blockers. Relieving spasm of the ureter wall to remove stone-like objects from the kidneys
drugs based on terpenes when observing small formations - cystenal, Avisan, enatine, artemizole. They help increase diuresis, provoke hypermia, have an antispasmodic effect, improve peristalsis, and have a bacteriostatic effect. The sedative effect provided by the drugs promotes better sleep and a less pronounced reaction to pain, which invariably occurs when formations come out.

Antibiotics

If the patient has stone formations resulting from the action of pathogenic microflora - Escherichia coli, coccal infections - it is recommended to include antibiotics in the treatment plan. On early stages diseases, they are irreplaceable due to their ability to penetrate directly into the source of infection and accumulate there in the concentration necessary to completely get rid of foreign microflora. They have also found widespread use before and after surgery. My patients use a proven remedy, thanks to which they can get rid of urological problems in 2 weeks without much effort.

The list of antibiotics used is extensive and includes:

fluoroquinolones
aminoglycosides
cephalosparins (III generation)
carbapenems.

Often an antibiotic is combined with an NSAID to quickly and completely eradicate the infection; the use of bactericidal and bacteriostatic drugs at the same time is strictly prohibited.

You should not select medications without consulting a doctor. Only a specialist can assess the clinical picture and prescribe adequate treatment.

They are prescribed by urologists taking into account the severity of the pathological process, the presence of renal colic, inflammation, and the type of stones. Medicines, as a rule, are selected on an individual basis, taking into account all the subtleties of the pathology in each individual case. Typically, specialists include antibacterial components in the treatment regimen that eliminate infectious inflammation in the kidneys and urinary tract and help reduce swelling of the organ parenchyma.

The prescription of medications for the correction of the pathological process is preceded by a thorough diagnosis with determination of the type of stones, their composition and size. Based on the results obtained, doctors distinguish several types of stones, according to their chemical content:

stones containing potassium, which are based on phosphates and oxalates, forming durable formations that are difficult to crush with medication;
stones formed through the impact of infectious agents on urine, which are destroyed with the help of medications that promote alkalization of urine;
uric acid stones that require an alkaline environment.

Therapy aimed at dissolving and crushing kidney stones has several important goals:

reducing the size of stones, which will allow them to be released gently through the urinary tract;
normalization of metabolic processes, helping to prevent the formation of new stones and an increase in existing ones;
elimination of inflammation in the kidney area and elimination of local swelling of soft tissues;
impact and normalization of local hemodynamics;
strengthening the immune system and stimulating the supporting mechanisms of the human body.

Treatment of urolithiasis with medications is indicated for patients in the following clinical cases:

for stones up to 0.6 cm in diameter, which are not capable of disrupting normal urodynamics and blocking the urinary tract;
frequent effective renal colic, which lasts no more than one day and is easily relieved with medications;
the presence of sand in the kidneys;
urates, the amounts of which are assessed as critical;
the addition of pathogenic microflora with the development of an infectious process in the kidney parenchyma.

Modern stone-dissolving and stone-expelling preparations

Stone-dissolving medications for kidney stones are the basis of treatment for the pathological condition. Modern medicine has a set of medications that gradually dissolve stone formations, which allows them to freely leave the renal tubular system. Among the most popular drugs with a similar mechanism of action among doctors and their patients are Allopurinol, Methionol, Blemaren solution, Magurlite, as well as benzoin and boric acid, ammonium chloride.

Unfortunately, such therapy does not always achieve the expected effect, which is explained by the peculiarities of the chemical composition of the stones or problems with the absorption of drugs. In this scenario, experts suggest that patients take advantage of stone-expelling drug forms, which are currently considered to be most effective against renal stones. Treatment of urolithiasis in a similar way is allowed only if the patient has stones whose diameter does not exceed 6 mm. If everything is done correctly, then the patient can expect that after the first course of therapy, about 2/3 of the rocky formations and sand will be gone.

The most effective means of combating urolithiasis, facilitating the rapid removal of kidney stones, are considered to be:

Progesterone, which affects alpha-adrenergic receptors of the ureters, reduces the muscle tone of the medial shell and expands the diameter of the passages;
smooth muscle relaxant Glucagon, which relaxes the muscle fibers of the ureters and facilitates the easy movement of stones through their lumen;
alpha blockers, which relax the smooth muscle fibers of the ureters;
Ca-channel blockers, the action of which is aimed at relieving spasm, which increases the likelihood of unhindered passage of stones through the ureters;
non-steroidal anti-inflammatory dosage forms, relieving pain and reducing local swelling of tissues.

The presence of small stones is an absolute indication for stimulating their spontaneous passage. In addition to the listed means of expelling stones, in modern medical practice, doctors use a technique using drugs containing terpenes. Chemical compounds This series has a pronounced antispasmodic effect, is endowed with sedative qualities and is able to influence the microbial flora due to bacteriostatic activity.

Terpenes are common and well-known medical forms that have a number of undeniable advantages that allow you to almost always make a choice in their favor:

increase the daily amount of urine;
help improve blood supply and microcirculation in the urinary organs;
have a bacteriostatic effect;
eliminates spasticity of smooth muscles of the urinary tract;
improves the peristaltic activity of the pathways along which stones move.

Among the most popular drugs in this series are:

Palin, which has a pronounced antibacterial effect;
Fitolysin paste, which is prescribed mainly in the postoperative period, as a drug that prevents relapses of the disease;
Canephron is a herbal medicine that improves the patient’s general condition and enhances the discharge of small formations;
effective tablet preparations for stones Enatin and Olimethine;
Cystine is a medicine based on herbal components that helps remove excess uric acid from the body, which is involved in the formation of stones.

Dependence of the effectiveness of dissolving therapy on the type of stones and their composition

With what type of stones does their complete dissolution become possible? Stones consisting of uric acid salts, that is, urates, are perfectly amenable to drug dissolution. In order to get rid of such formations, a therapy regimen is used aimed at alkalinizing urine using citrate mixtures or potassium bicarbonate. Before starting such treatment, the doctor must make sure that patients have no contraindications, including pyelonephritis in the acute phase, impaired renal function, and unsatisfactory urodynamics.

Citrate solutions should be prepared immediately before use. An adequate dosage of such drugs is 10 ml three times a day. This treatment regimen allows you to achieve the desired result in the form of getting rid of stones within 3-4 months from the start of therapy. Citrate preparations should be taken under the control of urine pH, which should not exceed 6.3-6.8.

It is important to remember that the dissolution of urate stones with medications always requires reinforcement in the form of a special diet with a limitation of foods that contain purine bases. Oxidation of urine is facilitated by the exclusion of their daily menu of meat, vegetable oil, cocoa, chocolate and coffee. At the same time, you should drink plenty of fluids (about 2.5-3 liters per day for an adult).

Antibiotics in the treatment of urolithiasis

Very often, urolithiasis is accompanied by the addition of bacterial microflora, which causes inflammation of the renal parenchyma and gradually destroys it. That is why, when determining kidney stones, it is advisable to use antibacterial drugs that eliminate foci of infection and have a powerful anti-inflammatory effect. Most often, doctors prescribe antibiotics from the following groups:

fluoroquinolones (“Ofloxacin”, “Lomifloxacin”), which are an effective means of combating infectious agents;
aminoglycosides (“Gentamicin”, “Amikacin”) – medicines, disrupting protein synthesis in bacteria, thereby preventing their growth and reproduction;
cephalosporins (Cefazolin, Cefepin) are antibiotics that have four generations of drugs with different activities against bacteria of one type or another.

It should be noted that complete sanitation of the source of infection in the kidney with urolithiasis is impossible, especially if the stone disrupts urodynamics. Therefore, antibacterial therapy takes place as preoperative preparation and for the prevention of infectious complications in the postoperative period.

Anti-inflammatory therapy

A direct indication for the prescription of non-steroidal anti-inflammatory drugs for urolithiasis is the presence inflammatory process in the tissues of the kidney with all its consequences, namely pain, swelling of the parenchyma, dysuria, and the like. Drugs from the NSAID group very rarely cause negative reactions from internal organs and have effects such as:

pain relief;
normalization of temperature indicators;
elimination of local edema;
improvement of ureteric patency.

Non-steroidal anti-inflammatory drugs are recommended to be used only after prescription by the attending physician.

Which painkillers are best?

Pain therapy – important point in the treatment of exacerbations of nephrolithiasis, which are accompanied by intense pain in the lumbar and abdominal areas, provoked by renal colic. When stones move through the ureters, pain relief cannot be avoided without medication. To relieve pain, urologists use analgesic drugs and antispasmodic drugs, which are equally effective in eliminating the pathological symptom, but have a different mechanism of action. Doctors often prefer to combine these medications to enhance the analgesic effect.

Antispasmodic drugs for urolithiasis can eliminate muscle spasms and thereby relieve a person from debilitating pain, which complicate the passage of stones through the urinary tract. In the acute period, antispasmodics are recommended to be used in the form of injections, but in their absence, the use of tablet forms of drugs is allowed. As a rule, in therapeutic practice, renal colic is relieved by intramuscular injection of No-shpa or Spasmalgon to the patient.

During an attack of renal colic, doctors prescribe narcotic and non-narcotic analgesics to patients. Opium drugs include Papaverine, known to many, which relieves spasms of smooth muscles and blocks the activity of pain receptors. The most popular non-narcotic analgesic is Baralgin, which can be administered intramuscularly and intravenously. In the period between attacks, people suffering from urolithiasis should not relax, waiting for the next episode of the disease. The medicine cabinet of such patients must certainly contain drugs that can quickly eliminate the symptoms of colic, which tends to occur suddenly against the background of complete well-being.

Diuretics

The function of the kidneys involves constant filtration of blood and removal from the body, along with urine, of various metabolites, metal salts, toxins, and the like. If the kidney cannot cope with its responsibilities, fluid accumulates in its parenchyma and provokes the development of edema. It is this disorder that is one of the first manifestations of dysfunction of the main urinary organ and a signal that it is time to visit a specialist in order to diagnose diseases that have caused a deterioration in general health.

It is advisable to prescribe diuretics for small stones that are not capable of creating a situation with blockage of the urinary tract. Also for such therapy, the composition of the stones and their ability to dissolve are of great importance. Potassium-sparing diuretics are prescribed to patients prone to the formation of phosphate or calcium stones. Whereas oxalates require the use of thiazide diuretics.

Any diuretic drug for urolithiasis can be replaced with a herbal remedy in the form of a herbal decoction or tincture. It must be remembered that medications with a diuretic effect can only be used with the permission of the attending physician and after clarifying all the nuances of the disease, as well as assessing the risks of developing its complications.

We should not forget that the treatment of urolithiasis must be comprehensive, so drug therapy alone is not enough in this case. Patients suffering from stone formation, after drug correction, are necessarily recommended to undergo a course of sanatorium treatment with mineral waters under laboratory control of the metabolism involved in the process of stone formation.

With urolithiasis, stones (calculi) form in the organs of the urinary system.

This disease is detected in almost half of patients who apply for medical care see a nephrologist or urologist.

Formation of stones in the genitourinary system

Most often, stones form in the kidneys, but they can also occur in the ureters, bladder and urethra.

The course of the disease largely depends on the general condition of the patient, his lifestyle, and the presence of concomitant pathologies.

In order to correctly select a medicine for the treatment of urolithiasis, it is necessary to know exactly the size, location and cause of the formation of stones.

Stones in the kidneys

Urolithiasis is a disease of the whole organism, and the formation of stones is only its consequence. This process is influenced by both endogenous and exogenous factors.

Endogenous causes of the development of urolithiasis include:

hypercalciuria, hypovitaminosis of vitamins A and D, overdose of calcium preparations;
bacterial infection with pyelonephritis or glomerulonephritis;
prolonged immobility after injury;
large doses of certain medications, such as sulfonamides, tetracycline antibiotics, antacids, aspirin, ascorbic acid, glucocorticoids;
various diseases of the urinary system that lead to disturbances in urodynamics (for example, nephroptosis, infections, neurogenic disorders of urine outflow, vesicoureteral reflux);
systemic metabolic disorders.

Exogenous causes are a person’s lifestyle (most often stones are formed due to physical inactivity), the composition and volume of food consumed. drinking water, diet.

In urolithiasis, stones are formed from a variety of salts and minerals. The generally accepted classification is based on the predominance of one or another element.

Most often, the formation of calcium oxolate and calcium phosphate stones occurs, less often - urate, cystine, xanthine and cholesterol stones.

Oxalate stones

Oxolate stones are formed when the excretion of oxolates in the urine is impaired. This can be caused by inflammatory processes in the intestines and prolonged diarrhea.

These stones are dark in color and have sharp edges.

During bacterial inflammatory processes, the formation of phosphate stones occurs. They acquire a white or gray tint and fall apart easily.

The risk of formation of urate stones is high with gout, cancer treatment as side effect chemotherapeutic agents. main reason formation - constant low urine pH.

They account for about 7% of cases of urolithiasis. They are usually brick-colored with a smooth surface.

As a result of malabsorption of basic amino acids (cystine, ornithine, lysine and arginine), their levels in the urine increase.

Compared to other amino acids, cystine is practically insoluble in water and precipitates. Cystine stones are subsequently formed from it.

Xanthine stones form extremely rarely with congenital enzyme deficiency. Cholesterol - for systemic disorders of cholesterol metabolism.

If urolithiasis is diagnosed, then the nature of the stone can be determined with a routine clinical urine test.

Each type of stone is characterized by a certain pH value.

Sometimes stones can also form in the bladder. This usually occurs in children and the elderly.

Symptoms

The manifestations of urolithiasis are influenced by the size, shape, number and location of stones.

If they have a smooth surface, do not injure the mucous membrane and do not interfere with the outflow of urine, then they can only be accidentally detected during an ultrasound examination of the kidneys and other organs of the urinary system.

Pain after exercise

Usually the first manifestation of urolithiasis is renal colic. Its cause is a violation of the outflow of urine from the kidney.

Obstruction of the ureter occurs due to blockage by a stone. In addition, the increased content of salts in the urine causes spasm of the muscles of its walls.

An attack of renal colic usually begins after a bumpy ride, running, jumping, lifting weights, or physical activity.

Suddenly a sharp, unbearable pain appears in the kidney area. It can radiate along the ureter to the perineum, inner thigh or leg.

Acute pain

The pain syndrome is so strong that a person is unable to tolerate it. He constantly changes his body position to try to relieve the pain.

When a stone passes into the ureter, it injures the internal mucous membrane of its walls. Therefore, blood may appear in the urine.

Very often, renal colic is accompanied by nausea, vomiting, and fever.

For some time, the pain subsides when the position of the stone changes and the outflow of urine is restored. Renal colic disappears completely when the stone leaves the body.

Urolithiasis with localization of stones in the bladder is accompanied by pain in the lower abdomen, especially when walking and physical activity.

Therefore, symptoms usually appear in daytime. A characteristic feature is a sudden interruption of urination. Manifestations of the disease weaken when the patient assumes a horizontal position.

Diagnostics

Choose correct treatment, necessary medications, timely diagnosis of urolithiasis will help determine whether antibiotics are needed.

Usually they start with a general blood test. When a bacterial infection is attached, the ESR and leukocyte level increase. A urine test is more informative.

Laboratory diagnostics

The pH level, the presence of bacteria, leukocytes, and salts are determined. When the walls of the ureter and bladder are damaged, red blood cells and transitional epithelial cells are detected.

Diagnostics

To determine the location, shape and size of the stone, ultrasound is most often performed. The value of this research method lies in its ease of implementation and the absence of contraindications.

In addition, an ultrasound examination can assess the general condition of the kidneys and the entire urinary system.

To confirm the diagnosis, X-ray examinations are done. A regular x-ray is not very informative, so to obtain a clearer picture, radiocontrast agents are administered.

This method is called excretory urography. The resulting images allow us to assess the size of the stone, its movement along the urinary tract, and the functional ability of the kidneys and bladder.

Before surgical treatment, a computed tomography or magnetic resonance imaging scan is usually performed.

Treatment

Since often the first sign of urolithiasis is an attack of renal colic, all efforts are aimed at stopping it. After the patient's condition has improved, further treatment is carried out.

Drug treatment

To facilitate the passage of stones through the urinary tract, medications are prescribed that relieve spasm of smooth muscles. First of all, it is baralgin.

The use of this medicine is most effective, since it additionally has an analgesic effect. No-spa and glucagon have an excellent antispasmodic effect on the muscles of the ureters.

Progesterone preparations also reduce the tone of the urinary tract.

Some hormones (for example, adrenaline and norepinephrine) increase smooth muscle spasm. To block their action, special drugs from the adrenergic blocking group are used.

Hormone therapy

These are drugs such as doxazosin, terazosin, alfuzosin.

The neurotransmitter acetylcholine acts selectively. It causes muscle contraction in all organs except the urinary system. Here its effect is exactly the opposite.

Medicines from the cholinomimetics group enhance its effect. These are hyoscine methyl bromide, atropine, spasmocystenal.

To stop the inflammatory process, non-steroidal anti-inflammatory drugs are used. These are ketorolac, diclofenac, and less commonly, acetylsalicylic acid.

Prescription of painkillers is mandatory. They are divided into two large groups, which differ in the strength of the analgesic effect.

These are non-narcotic analgesics (analgin, paracetamol, ibuprofen, nimesil) and narcotic (tramadol, omnopon, morphine, codeine). For severe pain, medications from the second group are used.

Sometimes a local novocaine or lidocaine blockade is performed.

If an attack of renal colic is accompanied by vomiting, then the drug metoclopramide is additionally used.

Catheterization

In order to reduce the formation of urine, take the medications desmopressin, minirin, presaynex or emosint.

In case of emergency, a combination of drugs is administered. Usually these are antispasmodic and anti-inflammatory drugs. Then, based on the patient’s condition, analgesics and antiemetics are added.

In severe cases, urine diversion is carried out using a catheter.

Usually, outside of an attack, you can take pills instead of injecting medications.

After relief of renal colic, a comprehensive examination of the patient is carried out. Based on its results, further treatment of urolithiasis is determined.

If the stones are small in size and can pass painlessly from the kidney, then a combination of medications is prescribed.

They improve renal blood circulation, increase diuresis, relieve spasm of the urinary tract and enhance their peristalsis, and prevent the development of bacterial complications.

Usually used:

enatine or olimethine are herbal preparations that have antispasmodic, diuretic and anti-inflammatory effects;
Rovatinex, a medicine that increases renal blood flow, has antispasmodic, anti-inflammatory and antimicrobial effects;
cystone, these tablets have anti-inflammatory and antimicrobial effects;
phytolysin not only has an antimicrobial, bacteriostatic and anti-inflammatory effect, but also loosens stones and facilitates their passage from the kidneys;
palin is an antibacterial medicine.

Urate stones dissolve well when long-term use such drugs as Uralit-U, blemaren, margulit. These medications not only help dissolve stones, but also prevent their further formation.

You need to take these drugs for about 2 – 3 months. In this case, regular monitoring of urine pH levels is necessary. It should not exceed 7.0.

A very serious complication of urolithiasis is bacterial inflammation of the kidneys - pyelonephritis. It is characterized by a sharp increase in temperature and aching pain in the lumbar region.

Antibiotics are used to treat this disease. Typically, the causative agents of pyelonephritis are Escherichia coli and Pseudomonas aeruginosa, streptococci, and staphylococci.

Therefore, antibacterial drugs are selected taking into account their effect on these groups of microorganisms.

For infectious complications of urolithiasis, the following antibiotics are effective:

third and fourth generation cephalosporins (ceftriaxone, sulfactam, cefotaxime, ceftazidime);
fluoroquinolones (levofloxacin, sparfloxacin, moxifloxacin);
sulfonamides (biseptol);
penicillins (amoxiclav, ampicillin, piperacillin).

Treatment with antibiotics

Antibiotic use usually lasts up to two weeks. In combination with these medications, it is necessary to use drugs to restore the intestinal microflora. These are Linex, Bio-Gaya, Bifidumbacterin or Bactisubtil.

After completing the course of therapy with antibacterial agents, uroseptic drugs are prescribed. These are medications such as urolesan, canephron, furagin.

They must be taken for a long time, possibly several months. The duration of treatment is determined by the attending physician.

Herbal medicine is also very useful: decoctions of lingonberry, bearberry, birch leaves, pol-palm grass, kidney tea, horsetail, chamomile flowers, calendula.

In addition to medications, there are also instrumental methods treatment of urolithiasis.

If the stones are easily dissolved, then special medications are injected directly into the kidney through a catheter.

This treatment is carried out if the size of the stones does not exceed 5 mm and they do not interfere with the normal functioning of the kidney.

Insoluble stones are removed with instruments that are inserted into the urethra, bladder or ureter through a catheter. These manipulations are carried out under ultrasound guidance.

The method of external shock wave lipotripsy involves the destruction of the stone by a shock wave. Stones up to 2 cm in size can be treated with this method of therapy.

There are contraindications to such a procedure.

These are excess body weight, diseases of the musculoskeletal system and cardiovascular system, pregnancy, acute infectious process in the genitourinary system, and impaired urine outflow.

In severe cases of urolithiasis, laparoscopic surgical treatment is indicated.

Treatment of urolithiasis in the presence of small stones in the kidney tissue consists of conservative therapy, which allows to relieve inflammation, improve the functioning of the urinary system, break stones into small fractions, and promote their removal naturally.

Clinical manifestations may not bother a person for a long time, but when the formations reach large sizes or block the outflow of urine, the symptoms are severe, it is necessary immediate treatment. According to medical observations, almost 95% of people with a history of urolithiasis have experienced an attack of renal colic, the treatment of which in the acute period consists of taking medications.

Drugs for urolithiasis are divided into symptomatic, which reduce the severity of symptoms, and systemic, which act on the cause itself. Only a doctor can prescribe any medicine after the patient has been admitted to the hospital and received the test results.

Principle of conservative therapy

Any medications for urolithiasis of the kidneys can only be prescribed by a doctor individually for each patient, taking into account the degree of the disease, the composition of the stones, and their size. The doctor should also pay attention to concomitant diseases and the general condition of the patient. The treatment regimen includes taking several drugs with systemic and symptomatic action. The mechanism of action of the drugs is aimed at:

elimination of infectious and inflammatory processes in the kidneys and urinary tract;
reduction of swelling of the organ parenchyma;
movement of stones through the urinary system;
dissolution of stones and removal of sand;
reducing the risk of relapse;
improvement and restoration of kidney function;
increased renal blood circulation;
relieving spasm of the smooth muscles of the ureters and pelvis.

Conservative therapy is indicated only when kidney stones do not exceed 0.6 cm in diameter and do not interfere with urodynamics and urine outflow. Indications for treatment pharmaceutical products Frequent renal colic occurs, which does not have pronounced symptoms and is easily relieved with the help of pharmaceutical drugs. A good result from drug therapy can be obtained in the presence of sand in the kidneys or small urates, the presence of pathogenic microflora, which provokes the development of an infectious process in the kidney parenchyma. If kidney stones are large, they interfere with the functioning of the urinary system, or drug treatment does not bring the desired result, the doctor will prescribe surgery as an emergency or planned procedure.

Groups of drugs used for urticaria

Treatment of kidney stones with medications always includes taking several medications aimed at reducing general symptoms, improving organ function, and reducing the risk of exacerbations. In the acute period of the disease with renal colic syndrome, therapy may consist of taking the following groups of drugs:

Anti-inflammatory drugs. They have an analgesic effect, reduce body temperature, relieve inflammation, fever and other symptoms of intoxication (Ibuprofen, Nimid, Paracetamol and others). You can take these pills for no more than 3-5 days.
Antispasmodics. Significantly relieve pain in renal colic, relieve spasms, and facilitate the passage of small stones. In case of a severe attack, unbearable pain, antispasmodics can be combined with anti-inflammatory drugs. Antispasmodics include No-Shpu, Droteverin, Spazmalgon and others.
Diuretics are prescribed only for small formations in the renal tissues. Taking such medications allows you to increase the frequency of the urge to urinate, thereby reducing swelling and reducing the risk of congestion (Diacarb, Lasix, Veroshpiron, Furosemide).
Antibiotics prescribed in the presence or occurrence of a bacterial infection. Basically, doctors prescribe broad-spectrum drugs from the group of cephalosporins, penicillins, and gentamicins. Taking antibiotics has no effect on stones, only eliminates inflammation and suppresses the aggressiveness of pathogenic bacteria.
Sulfanilamide have a pronounced antimicrobial effect. Such drugs do not destroy pathogenic pathogens, but only stop their growth and development (Monural, Palin, Urosulfan and others).
Drugs of the nitrofuran series– synthetic antibacterial drugs for wide medical use. These drugs are inferior to some antibiotics, but they are still widely used in the treatment of diseases of the urinary system (Furadonin, Furangin, Furazolidone).
Medicines that improve blood microcirculation in renal tissue (Pentoxifylline, Trental, Agapurin).
Vegetable. They have anti-inflammatory, diuretic, antispasmodic properties, dissolve small stones, and promote their painless passage. Drugs from this group can be used for children and pregnant women, are well tolerated, and interact well with other drugs: Phytolysin, Canephron, Cyston and others.

Persons suffering from urolithiasis must strictly follow all doctor’s recommendations and take medications as prescribed. In a hospital setting, most drugs are administered intramuscularly or intravenously, which allows for quick effect from treatment. Only a urologist or nephrologist can prescribe any drugs for the treatment of urolithiasis and only after receiving the diagnostic results. The choice of therapy depends not only on the size and location of the stones, but also on their composition.

If you have kidney disease, you need to take various medicinal infusions and tablets with extreme caution, since any drug has its own contraindications and side effects that can negatively affect the general condition of the patient, provoke complications, and worsen the prognosis for recovery.

Antibiotics are an important part of treatment

Antibiotics are not always prescribed for urolithiasis in women or men, but only when struvite stones, which contain magnesium and ammonium salts, are diagnosed. Such stones most often form during infections in the urinary tract and kidneys under the influence of E. coli, staphylococci, and enterococci. Indications for antibacterial therapy may also include concomitant diseases of the genitourinary system, which often worsen under the influence of kidney stones, thereby provoking renal colic.

Treatment with antibiotics is especially effective in the initial stages of the disease. Administration of drugs can occur orally or intravenously. The active components of the drugs have the ability to penetrate into the source of inflammation, suppress and destroy pathogenic flora. The most commonly used antibiotics are:

Ampicillins (Amoxicillin, Penicillin).
Cephalosporin drugs (Zinnat, Cefalotin, Tamycin, Cephalexin and Claforan).
Aminoglycosides (Netilmicin, Gentamicin, Amikacin).
First generation fluoroquinols (Ofloxacin, Ciprofloxacin).
Amino and carboxypenicillins (Ampicillin, Ampiox, Carbenicillin).

Treatment with antibiotics takes from 7 to 14 days. It all depends on the stage of the disease, the localization of the inflammatory process, and the pathogen. Often, with urolithiasis, exacerbation or development of infectious complications occurs. Such conditions are observed in people suffering from chronic pyelonephritis, cystitis, and acute glomerulonephritis. If there is a history of such diseases, then in the acute period of the disease, taking antibiotics is an important part of therapy.

Conclusion

Kidneys are an important organ of the human body; for them to function properly, it is important to reduce or completely eliminate alcohol consumption and avoid salty, spicy and fatty foods. You need to drink as much water as possible, healthy image life, and at the first indisposition, consult a doctor as soon as possible. If you have a history of urolithiasis, you should not self-medicate, take medications uncontrollably, or hope for “miracles” of alternative medicine. Seeing a doctor for a full examination will help make the correct diagnosis and assess the general condition of the patient. Only a doctor can give advice on what medications a patient should take, prescribe a diet, and give useful recommendations on treatment and lifestyle.

Urolithiasis (UCD) is a metabolic disorder that leads to the formation of stones (calculi) in the urinary tract (urolithiasis) and kidneys (nephrolithiasis). The use of the terms “urolithiasis” and “nephrolithiasis” as synonyms is not entirely correct.

ICD is diagnosed at different ages. However, in most patients, this disease occurs during the working period (30-50 years).
A little more often, the area where stones are localized is the right kidney, and bilateral kidney damage occurs in every fifth case of urolithiasis.

The main causes of ICD are exogenous and endogenous factors:
Endogenous

Disturbances in the properties of urine (failures in the metabolism of oxalic acid, purine metabolism). Birth defects and urinary tract injuries. Bacterial infections. Pathologies of the genitourinary system leading to urinary disorders (pyelonephritis, nephroptosis, hydronephrosis, cystitis and others). Inherited genetic diseases (cystinuria). Taking medications containing calcium and sulfonamides. Lack of vitamins A and B6 in the body, excess D, C. Sedentary lifestyle and quality of food consumed.

Treatment methods for urolithiasis can be conservative, instrumental, or surgical. They are prescribed depending on:

etiology; metabolic disorders; urodynamic conditions; urine pH; kidney function; location of the stone; the chemical composition of the stone and its size; associated complications.

Diagnosis and treatment are made based on the results of the following examinations: general urinalysis, ultrasound, radiography of the pelvic organs, intravenous urography, cystoscopy.

To choose the right treatment, it is necessary to determine what components the stones are made of.

There are several types based on their chemical composition. Approximately 60-80% of all stones are inorganic calcium compounds: weddellite, wewellite (calcium oxalate), whitlockite, apatite, brushite, hydroxyapatite (calcium phosphate). Stones formed from uric acid and its salts (uric acid dihydrate, ammonium and sodium urates) occur in 7-15% of patients. Stones containing magnesium (newberite, struvite) make up about 7-10% of all stones and often accompany infection. Cystine stones are quite rare (1-3%). Stones that completely occupy the renal pelvis are called coral stones.

The simultaneous disturbance in several metabolic links and concomitant infection is indicated by the mixed composition of stones, detected in most cases. It has been proven that climatic and geographical factors, living conditions, and the content of various salts in drinking water and food products affect chemical composition stones.

Medicines used for nephrolithiasis and urolithiasis

Treatment of urolithiasis is based on the use of pharmacological drugs. When taken, the risk of recurrent stone formation is reduced due to the correction of biochemical parameters in the urine and blood.

In addition, they facilitate the process of passing small stones (up to 5mm).

The method of litholysis, as a rule, affects urates. Considering that such stones are formed at a reduced urine pH, it is necessary to maintain the pH balance at a level of elevated values (6.2-6.8) - to alkalize the urine. This effect is achieved with the drugs blemaren, uralit U, soluran, margulit and others.

Blemarin is available in the form of effervescent tablets or granular powder, and is supplied with a control calendar and indicator paper. It contains citric acid salts - potassium or sodium citrate, which together create an increased concentration of potassium and sodium ions in the urine. However, we must not forget that when using citrate mixtures, phosphate and oxalate stones can form (at a urine pH of more than 7). This happens because lemon acid increases the concentration of oxalic acid in the urine.

The use of litholysis for stones with a different chemical structure is auxiliary. Medicines based on citrates help dissolve not only urates, but also small calcifications and mixed stones. In addition, they help slow down the stone formation process. However, the alkalization method must be carried out in the absence of other diseases of the genitourinary system.

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Spasmoanalgesics

Antispasmodic drugs relieve pain during attacks of renal colic. They facilitate the passage of small stones and reduce swelling of the tissue when the stone remains in the organs for a long time. As a rule, colic is accompanied by severe pain and fever, so in some cases it makes sense to combine the use of antispasmodics with anti-inflammatory non-steroidal drugs.

According to the mechanism of action, antispasmodic drugs are divided into neurotropic and myotropic.

The antispasmodic effect of neurotropic drugs is aimed at blocking the transmission of nerve impulses to nerve endings that stimulate smooth muscle tissue. Myotropic antispasmodics reduce muscle tone.

Neurotropic drugs - M-anticholinergics (atropine, metacin, scopolamine) are not often used for urolithiasis, since they have pronounced side effects and low antispasmodic activity.

The myotropic antispasmodic drotaverine is widely used in Russia. It selectively blocks PDE IV (phosphodiesterase), which is found in the smooth muscles of the urinary tract. This achieves an increased concentration of cAMP (adenosine monophosphate), due to which muscle relaxation occurs, swelling and inflammation caused by PDE IV are reduced.

Alpha-blockers (tamsulosin, alfuzosin and others) can act as stimulants for spontaneous stone passage.

Tamsulosin helps reduce tone and improve detrusor function. This medicine is used once a day, 400 mg. Severe liver disease and orthostatic hypotension are contraindications to the use of this drug.

If there are stones in the ureters and renal colic accompanying this process, analgesics-antispasmodics, such as maxigan, spasmalgon, trigan, baralgin, are prescribed. To relieve pain, it is recommended to use baralgin orally or intramuscularly in combination with Avisan or No-shpa (drotaverine) 1 tablet. If their action turns out to be ineffective, intramuscular administration of diclofenac (dicloran, voltaren and the like) is carried out. Also in these cases, there is a reason to prescribe nonspecific anti-inflammatory drugs (indomethacin, piroxicam) and therapy with hepaprotectors that have antioxidant activity (Essentiale, Lipostabil, Phospholip and others). Often, for urolithiasis, lytic mixtures containing promedol or analgesics such as pentazocine, tramadol, butorphanol are indicated for use.

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Antimicrobial and anti-inflammatory drugs

Antibiotics are prescribed to patients with struvite stones because stones of mixed magnesium and ammonium salts form due to infection caused by microorganisms. Most often, the urinary tract is infected with Escherichia coli, less often with staphylococci and enterococci.

Treatment with antibiotics is considered effective at the initial stage of therapy. After observing the clinical picture of the disease, drugs are administered orally or intravenously. The antibiotic has the ability to penetrate into the site of inflammation and accumulate there in the required concentrations.

The simultaneous prescription of bacteriostatic and bactericidal antibiotics is unacceptable. In order to prevent the occurrence of bacteriotoxic shock, you should not take antibacterial drugs if there are disturbances in the outflow of urine. The duration of antibiotic treatment should be at least one to two weeks.

When the urinary tract is damaged by bacteria, the following types of drugs are most often used:

Fluoroquinolones (ofloxacin, ciprofloxacin, lomefloxacin, pefloxacin, gatifloxacin, levofloxacin). III (ceftriaxone, ceftazidime) and IV generation cephalosporins (cefepime). Aminoglycosides (amikacin, gentamicin). Carbapenems (meropenem, imilenem/cilastatin).

Fluoroquinolones are used for infections caused by aerobic bacteria - staphylococci, Pseudomonas aeruginosa, Shigella.

Cephalosporims are highly bactericidal and have a wide field of action. The latest generation of drugs are active against gram-positive and gram-negative microorganisms, including strains resistant to aminoglycosides.

All aminoglycoside antibiotics in small doses cause bacteriostasis (stop protein synthesis), in large doses they cause a bactericidal effect.

Carbapenems are equally active against aerobic and anaerobic bacteria. When treated with these drugs, peptidoglycan synthesis is inhibited and bacteria are lysed. However, with long-term treatment there is a risk of pseudomembranous enterocolitis.

Anti-inflammatory non-steroidal drugs (NSAIDs) are prescribed in combination with antibiotics when an infection is detected in order to destroy the source of inflammation. Such drugs include ketoprofen, ketorolac, diclofenac and others. However, these drugs are ulcerogenic, so they must be taken with great caution.

If the inflammation process is insignificant, drugs of the nitrofuran series (furadonin, furangin, furazolidone), pipemidic acid (pimidel, palin), oxolinic acid (dioxacin, gramurin), norfloxacin (norflox, nolitsin), sulfonamides (etazol, biseptol and others) are prescribed.
Medicines that correct biochemical changes in the blood and urine

Allopurinol is a drug that reduces the formation of uric acid both in excretory products and in the blood serum, thereby preventing its accumulation in tissues and kidneys. Allopurinol is prescribed to patients with recurrent urolithiasis due to calcium oxolate stones. This drug is prescribed immediately when biochemical changes are detected.

Drugs that correct the biochemical composition of urine include thiazide diuretics (indapamide, hypothiazide).

Also, with KSD, it is important to take drugs that promote microcirculation in tissues (trental, pentyline, pentoxifylline, pentilin, relofect and others), as well as taking calcium antagonists (verapamil). These medications are prescribed together with antibiotics.

However, if the stone disrupts urodynamics, complete elimination of the infection in urolithiasis does not occur. As a rule, antibacterial therapy is prescribed before and after surgery.

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Preparations containing herbal ingredients

If there are stones in the body that doctors predict will be able to pass away on their own, medications containing terpenes are prescribed. They improve blood circulation in the kidneys and increase diuresis.

In addition, by enhancing peristalsis, they promote the passage of stones. This group of drugs includes cystenal, enatin, phytolysin, Avisan, and artemizole. Most of these drugs are contraindicated in patients with peptic ulcer, with impaired renal function, with chronic and acute glomerulonephritis.

Cystenal, a drug containing tincture of madder root, various essential oils, magnesium salicylate. It is available in the form of an alcohol tincture. To block an attack of colic, it is recommended to take 20 drops of a medicine containing sugar.

Alcohol tincture artemizole contains essential oils of wormwood paniculata and peppermint leaves, and peach oil. Its pharmacological action is similar to cystenal. You need to apply a few drops (depending on the clinical picture) under the tongue on a piece of sugar. The course of treatment is 10-20 days.

Olymethrin and enatine are similar in composition: peppermint, terpene oils, calamus, olive, purified sulfur. They are taken 1 tablet up to 5 times a day.

Cyston, consisting of extracts of many plants (Saxifrage reedulata, Dicarpus cauliflower, Membranaceae, Onosoma bractifolia, Madder cordifolia, Ash vernonia, Rough strawberry), mumiyo powder and lime silicate, helps reduce spontaneous crystallurgy and stabilizes the crystal-colloid balance. Thanks to its active substances, the concentration of elements that promote stone formation is reduced, and it has diuretic, antimicrobial, antispasmodic, and anti-inflammatory effects.

The use of cystone can be prescribed as monotherapy or in combination with additional drugs for urolithiasis and other ailments of the urinary system. For urolithiasis, in complex therapy, a daily dose of cystone is prescribed, 2 tablets 2-3 times. Treatment can last up to six months or until the stones pass.

The composition of the Polish preparation phytolysin includes terpenes and other essential oils containing flavin, saponins, inositol, glycosides (sage, pine needles, peppermint), extracts of parsley seeds, birch leaves, horsetail grass, wheatgrass rhizomes, etc.) The paste-like product provides antispasmodic, bacteriostatic, diuretic effect. It has an excellent anti-relapse effect after surgery. One teaspoon of paste, diluted with 100 ml of sweet water, is consumed 3-4 times a day. With long-term use of this drug, no negative effects on the body were observed.

The German drug Nieron contains tincture of ammonium tartar, madder, field steelhead, calendula, and oxalinic acid. It improves the blood supply to the kidneys and muscles, has an enhancing effect on urinary tract motility, and has a diuretic and bacteriostatic effect. Nieron is consumed up to 3 times a day, 30-35 drops, for 1-2 months. IN postoperative period nierone is prescribed as an anti-relapse and anti-inflammatory agent.

Canephron improves the condition of the body as a whole, promotes increased release of urate stone formations, improves general indicators of urine analysis, phosphorus-calcium metabolism, creatinine, reduces the permeability of blood vessels, and enhances the effect of antibiotics. The therapeutic effect of canaferon is due to its constituent extracts of centaury, lovage, rose hips, rosemary, ascorbic, citric, pectic and malic acids, and vitamins.

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Herbal treatment

Herbal infusions are an important part of complex therapy and preventive measures for the occurrence of urolithiasis. Antiseptic, antispasmodic, diuretic effect on urinary tract stones is exerted by herbal infusions, which contain: roots of parsley, madder, horsetail, steelhead, juniper berries, rose hips, peppermint leaves, stinging nettle and other plant components. It is important to know that some herbal infusions cannot be taken if you have glomerulonephritis.

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Preventive actions

Urolithiasis is prone to recurrence, so preventive measures are very important. When making the initial diagnosis, it is necessary to find out the nature of the stones formed in the urinary system. Thanks to this, it is possible to adjust nutrition, as well as prescribe anti-relapse, preventive drug treatment.

With urolithiasis, stones (calculi) form in the organs of the urinary system.

This disease is detected in almost half of patients who seek medical help from a nephrologist or urologist.

Formation of stones in the genitourinary system

Most often, stones form in the kidneys, but they can also occur in the ureters, bladder and urethra.

The course of the disease largely depends on the general condition of the patient, his lifestyle, and the presence of concomitant pathologies.

In order to correctly select a medicine for the treatment of urolithiasis, it is necessary to know exactly the size, location and cause of the formation of stones.

Causes of stone formation

Stones in the kidneys

Urolithiasis is a disease of the whole organism, and the formation of stones is only its consequence. This process is influenced by both endogenous and exogenous factors.

Endogenous causes of the development of urolithiasis include:

hypercalciuria, hypovitaminosis of vitamins A and D, overdose of calcium preparations; bacterial infection with pyelonephritis or glomerulonephritis; prolonged immobility after injury; large doses of certain medications, such as sulfonamides, tetracycline antibiotics, antacids, aspirin, ascorbic acid, glucocorticoids; various diseases of the urinary system that lead to disturbances in urodynamics (for example, nephroptosis, infections, neurogenic disorders of urine outflow, vesicoureteral reflux); systemic metabolic disorders.

Exogenous causes are a person’s lifestyle (stones are most often formed due to physical inactivity), the composition and volume of drinking water consumed, and diet.

In urolithiasis, stones are formed from a variety of salts and minerals. The generally accepted classification is based on the predominance of one or another element.

Most often, the formation of calcium oxolate and calcium phosphate stones occurs, less often - urate, cystine, xanthine and cholesterol stones.

Oxalate stones

Oxolate stones are formed when the excretion of oxolates in the urine is impaired. This can be caused by inflammatory processes in the intestines and prolonged diarrhea.

These stones are dark in color and have sharp edges.

During bacterial inflammatory processes, the formation of phosphate stones occurs. They acquire a white or gray tint and fall apart easily.

The risk of urate stone formation is high in gout and cancer treatment as a side effect of chemotherapy drugs. The main reason for the formation is the constant low pH value of urine.

They account for about 7% of cases of urolithiasis. They are usually brick-colored with a smooth surface.

As a result of malabsorption of basic amino acids (cystine, ornithine, lysine and arginine), their levels in the urine increase.

Compared to other amino acids, cystine is practically insoluble in water and precipitates. Cystine stones are subsequently formed from it.

Xanthine stones form extremely rarely with congenital enzyme deficiency. Cholesterol - for systemic disorders of cholesterol metabolism.

If urolithiasis is diagnosed, then the nature of the stone can be determined with a routine clinical urine test.

Each type of stone is characterized by a certain pH value.

Sometimes stones can also form in the bladder. This usually occurs in children and the elderly.

Symptoms

The manifestations of urolithiasis are influenced by the size, shape, number and location of stones.

Pain after exercise

Usually the first manifestation of urolithiasis is renal colic. Its cause is a violation of the outflow of urine from the kidney.

Obstruction of the ureter occurs due to blockage by a stone. In addition, the increased content of salts in the urine causes spasm of the muscles of its walls.

An attack of renal colic usually begins after a bumpy ride, running, jumping, lifting weights, or physical activity.

Suddenly a sharp, unbearable pain appears in the kidney area. It can radiate along the ureter to the perineum, inner thigh or leg.

Acute pain

The pain syndrome is so strong that a person is unable to tolerate it. He constantly changes his body position to try to relieve the pain.

When a stone passes into the ureter, it injures the internal mucous membrane of its walls. Therefore, blood may appear in the urine.

Very often, renal colic is accompanied by nausea, vomiting, and fever.

For some time, the pain subsides when the position of the stone changes and the outflow of urine is restored. Renal colic disappears completely when the stone leaves the body.

Urolithiasis with localization of stones in the bladder is accompanied by pain in the lower abdomen, especially when walking and physical activity.

Therefore, symptoms usually appear during the daytime. A characteristic sign is a sudden interruption of urination. Manifestations of the disease weaken when the patient assumes a horizontal position.

Diagnostics

Timely diagnosis of urolithiasis will help you choose the right treatment, the necessary medications, and determine whether antibiotics are needed.

Usually they start with a general blood test. When a bacterial infection is attached, the ESR and leukocyte level increase. A urine test is more informative.

Laboratory diagnostics

The pH level, the presence of bacteria, leukocytes, and salts are determined. When the walls of the ureter and bladder are damaged, red blood cells and transitional epithelial cells are detected.

Diagnostics

To determine the location, shape and size of the stone, ultrasound is most often performed. The value of this research method lies in its ease of implementation and the absence of contraindications.

In addition, an ultrasound examination can assess the general condition of the kidneys and the entire urinary system.

To confirm the diagnosis, X-ray examinations are done. A regular x-ray is not very informative, so to obtain a clearer picture, radiocontrast agents are administered.

This method is called excretory urography. The resulting images allow us to assess the size of the stone, its movement along the urinary tract, and the functional ability of the kidneys and bladder.

Before surgical treatment, a computed tomography or magnetic resonance imaging scan is usually performed.

Treatment

Since often the first sign of urolithiasis is an attack of renal colic, all efforts are aimed at stopping it. After the patient's condition has improved, further treatment is carried out.

Drug treatment

To facilitate the passage of stones through the urinary tract, medications are prescribed that relieve spasm of smooth muscles. First of all, it is baralgin.

The use of this medicine is most effective, since it additionally has an analgesic effect. No-spa and glucagon have an excellent antispasmodic effect on the muscles of the ureters.

Progesterone preparations also reduce the tone of the urinary tract.

Some hormones (for example, adrenaline and norepinephrine) increase smooth muscle spasm. To block their action, special drugs from the adrenergic blocking group are used.

Hormone therapy

These are drugs such as doxazosin, terazosin, alfuzosin.

The neurotransmitter acetylcholine acts selectively. It causes muscle contraction in all organs except the urinary system. Here its effect is exactly the opposite.

Medicines from the cholinomimetics group enhance its effect. These are hyoscine methyl bromide, atropine, spasmocystenal.

To stop the inflammatory process, non-steroidal anti-inflammatory drugs are used. These are ketorolac, diclofenac, and less commonly, acetylsalicylic acid.

Prescription of painkillers is mandatory. They are divided into two large groups, which differ in the strength of the analgesic effect.

These are non-narcotic analgesics (analgin, paracetamol, ibuprofen, nimesil) and narcotic (tramadol, omnopon, morphine, codeine). For severe pain, medications from the second group are used.

Sometimes a local novocaine or lidocaine blockade is performed.

If an attack of renal colic is accompanied by vomiting, then the drug metoclopramide is additionally used.

Catheterization

In order to reduce the formation of urine, take the medications desmopressin, minirin, presaynex or emosint.

In severe cases, urine diversion is carried out using a catheter.

Usually, outside of an attack, you can take pills instead of injecting medications.

After relief of renal colic, a comprehensive examination of the patient is carried out. Based on its results, further treatment of urolithiasis is determined.

If the stones are small in size and can pass painlessly from the kidney, then a combination of medications is prescribed.

They improve renal blood circulation, increase diuresis, relieve spasm of the urinary tract and enhance their peristalsis, and prevent the development of bacterial complications.

Usually used:

enatine or olimethine are herbal preparations that have antispasmodic, diuretic and anti-inflammatory effects; Rovatinex, a medicine that increases renal blood flow, has antispasmodic, anti-inflammatory and antimicrobial effects; cystone, these tablets have anti-inflammatory and antimicrobial effects; phytolysin not only has an antimicrobial, bacteriostatic and anti-inflammatory effect, but also loosens stones and facilitates their passage from the kidneys; palin is an antibacterial medicine.

Urate stones dissolve well with long-term use of drugs such as Uralit-U, blemarene, and margulit. These medications not only help dissolve stones, but also prevent their further formation.

Stones

You need to take these drugs for about 2 – 3 months. In this case, regular monitoring of urine pH levels is necessary. It should not exceed 7.0.

A very serious complication of urolithiasis is bacterial inflammation of the kidneys - pyelonephritis. It is characterized by a sharp increase in temperature and aching pain in the lumbar region.

Antibiotics are used to treat this disease. Typically, the causative agents of pyelonephritis are Escherichia coli and Pseudomonas aeruginosa, streptococci, and staphylococci.

Therefore, antibacterial drugs are selected taking into account their effect on these groups of microorganisms.

For infectious complications of urolithiasis, the following antibiotics are effective:

third and fourth generation cephalosporins (ceftriaxone, sulfactam, cefotaxime, ceftazidime); fluoroquinolones (levofloxacin, sparfloxacin, moxifloxacin); sulfonamides (biseptol); penicillins (amoxiclav, ampicillin, piperacillin).

Treatment with antibiotics

After completing the course of therapy with antibacterial agents, uroseptic drugs are prescribed. These are medications such as urolesan, canephron, furagin.

They must be taken for a long time, possibly several months. The duration of treatment is determined by the attending physician.

Herbal medicine is also very useful: decoctions of lingonberry, bearberry, birch leaves, pol-palm grass, kidney tea, horsetail, chamomile flowers, calendula.

In addition to medications, there are also instrumental methods for treating urolithiasis.

If the stones are easily dissolved, then special medications are injected directly into the kidney through a catheter.

This treatment is carried out if the size of the stones does not exceed 5 mm and they do not interfere with the normal functioning of the kidney.

Insoluble stones are removed with instruments that are inserted into the urethra, bladder or ureter through a catheter. These manipulations are carried out under ultrasound guidance.

The method of external shock wave lipotripsy involves the destruction of the stone by a shock wave. Stones up to 2 cm in size can be treated with this method of therapy.

There are contraindications to such a procedure.

These are excess body weight, diseases of the musculoskeletal system and cardiovascular system, pregnancy, acute infectious process in the genitourinary system, and impaired urine outflow.

In severe cases of urolithiasis, laparoscopic surgical treatment is indicated.