Preparations for the treatment of urolithiasis. "Enatin" for the treatment of urolithiasis

Urolithiasis (synonym: urolithiasis) is a urological disease that is characterized by the deposition of stones in the urinary system. Stones can become lodged in one of the ureters, the bladder, or the urethra, causing renal colic, dysuria (difficulty urinating), or hematuria (blood in the urine). In the article we will analyze the treatment urolithiasis in women – drugs and their mechanism of action.

In the International Classification of Diseases, 10th revision (ICD-10), urolithiasis is designated by code N20.

Treatment depends on the type, volume and location of the stones. Small crystals - less than 5 mm - often leave the body on their own; if the size is 5 to 10 millimeters, therapy with alpha blockers is recommended. More complex treatment is usually not required. Urinary stones can sometimes be dissolved using medication.

Most large crystals that do not leave the body on their own must be removed by shock wave therapy or endoscopic surgery. The absolute indication for surgical intervention is a stone larger than 10 millimeters.

About 30-50 out of every 100 people who have had a kidney stone have a recurrence within five years. Since there are many causes of urolithiasis, it is important to know chemical composition crystals.

It is important to know! Approximately 80% of all kidney stones are calcium oxalate or calcium phosphate. Triple phosphate stones are most common, while urate stones occur only in 5-10% of patients. The remaining types consist of struvite, cystine or other rarer substances.

To reduce the risk of crystal formation, you need to drink enough fluids and, if necessary, change your diet. Large randomized studies show that proper water consumption reduces the risk of urolithiasis by three times.

Many soft drinks - especially colas - contain phosphoric acid ( food supplement E338). E-substance may contribute to the formation of kidney stones. Therefore, abstaining from cola also reduces the risk of urolithiasis.

Both calcium and oxalate are found in many foods. However, the ratio of chemical compounds in food is more important than their concentration: research shows that a diet low in calcium favors stone formation because it increases the concentration of oxalate in the blood.

In patients with gout and diabetes, urate stones are most common. Uric acid is a breakdown product of so-called “purines”: they are formed in the body, but also partially enter it with food. Therefore, to prevent uric acid stones, it is recommended to use a diet with a reduced concentration of purines: reduce the amount of fish, meat and seafood consumed. There are no scientific studies yet that have examined the effect of a low-purine diet on the risk of urate stones.

Crystalline deposits less than 2 cm in diameter are treated with shock wave therapy. If the stones are larger than 2 centimeters, they are usually removed using an endoscope. Large stone formations in the lower part of the ureter are eliminated mainly through the urethra. The choice of treatment method depends on the patient’s condition and the anatomical location of the pathology.

Indications for drug therapy

Small stones often leave the body on their own and do not require surgery or medication unless they cause serious discomfort or complications.

Advice! Medications are recommended for use in the postoperative period if there is a high risk of recurrence of urolithiasis. Large crystals often need to be removed surgically. Depending on their location and size, endoscopic surgical treatment is required.

Indications for use of drugs:

the occurrence of stones in childhood or adolescence;
family predisposition;
certain diseases of the kidneys, urinary tract, or gastrointestinal tract(at-risk groups);
urinary tract infections;
hyperuricemia;
the presence of cystine stones (caused by a rare inherited metabolic disorder).

Review of drugs for the treatment of kidney stones

If discomfort occurs due to severe urolithiasis, both women and men can benefit from anti-inflammatory medications - Diclofenac, Paracetamol or Ibuprofen. Medications inhibit cyclooxygenase and prevent the formation of prostaglandins, mediators of inflammation and pain.

Alpha blockers are prescribed to help stones pass through the ureter. The drugs relax the muscles in the lower part Bladder. They are also used to treat benign hyperplasia prostate. Tamsulosin is not approved for the treatment of urolithiasis, but is often prescribed in conjunction with other medications.

According to current scientific evidence, alpha-blockers can significantly improve the passage of stones through the ureter. This was shown in an assessment of 55 studies:

Without alpha blockers, about 50 out of 100 people were cured within four weeks.
With the help of drugs, stones were eliminated in about 75 out of 100 people within 4 weeks.

Temporary adverse effects of medications include low blood pressure, dizziness and fatigue. In a large study, 4 out of 100 people stopped treatment due to severe side effects. 5 out of every 100 men have experienced “dry ejaculation”: semen is expelled into the bladder rather than into the external space.

Groups of drugs and their general characteristics

For urolithiasis of the kidneys, alkaline drugs or sodium carbonate are used, sometimes Allopurinol. Soda ash increases the pH of urine, and Allopurinol reduces the level of uric acid. To increase the effectiveness of medications, you need to drink a lot of water to produce more urine and dissolve uric acid.

The main classes of drugs prescribed for urolithiasis:

Nonsteroidal anti-inflammatory drugs (NSAIDs): Reduce pain and inflammation.
Alkalinizing agents: Increase urine pH.
Xanthine oxidase inhibitors: block the enzyme involved in the breakdown of purines into uric acid.
Diuretics: accelerate urine excretion (diuretic effect).
Antibiotics: fight against bacterial microorganisms.
Alpha blockers: dilate smooth muscle and improve the passage of stones through the ureter.

Dependence of the choice of medication on the type of stones

Different types of stones have different compositions, which influence the choice of treatment tactics. Below is a list that presents drugs for the treatment of urolithiasis depending on the stones:

Description of individual representatives and application diagram

Tablets for urolithiasis are taken daily. Typically, they are only considered if there has been a relapse or the patient's condition has deteriorated significantly. In large-scale studies, medications to prevent urolithiasis have been shown to help prolong remission.

Potassium citrate has been shown to be effective in several studies:

Without potassium citrate, 53 out of 100 people relapsed within two years.
With the drug, 13 out of 100 people developed one kidney stone over a two-year period.

Possible side effects of potassium citrate are gastrointestinal discomfort and diarrhea. In studies, about 13 out of 100 people stopped treatment due to adverse effects.

Thiazide diuretics have also been used in studies to reduce the risk of kidney stones. They may have various side effects. These include low blood pressure with dizziness and fatigue, dry mouth and erectile dysfunction.

Allopurinol is primarily used for the prevention of urate stones. However, until now its effectiveness has only been studied in studies of people with calcium stones. They showed that the drug can protect against oxalate and phosphate crystals. The substance can cause a rash and sometimes an attack of gout. However, in the trials, the majority of patients did not discontinue allopurinol treatment due to side effects.

Antibiotics for infectious urolithiasis can only be taken under the supervision of a doctor. It is recommended to use ampicillin or other broad-spectrum antimicrobial agents.

Pain and other symptoms during the acute period should be treated with analgesics. Homeopathic painkillers have a placebo effect and are therefore not recommended as symptomatic or etiotropic treatment.

It is important to know! Mineral water also helps dissolve and remove stones.

Treatment of stones in men and therapy in women: is there a difference?

The causes and symptoms of the development of stones in the structures of the urinary tract may differ in individuals of different sexes. But there is no clinically significant difference between the treatment of urolithiasis in men and women. Sex differences in the treatment of urolithiasis have not been identified in any large randomized trial.

Therapy prognosis

Timely conservative or surgical therapy helps 95% of patients go into remission. Over the next 5 years, 60% develop a relapse (recurrence of the disease). Patients are advised to stay hydrated and exercise regularly. It is strictly forbidden to self-medicate at home with untested herbs or alternative methods. Many drugs have unproven clinical effectiveness and may cause more harm than potential benefit.

Urolithiasis is a common pathology characterized by difficulty urinating and pain in the abdominal area. Symptoms and treatment in women depend on the stage of the pathology. In the initial stages, the disease does not cause serious problems and quickly responds to therapeutic measures.

Urolithiasis (symptoms and treatment in women will be discussed in the article) is characterized by the presence of stones in one of the sections of the urinary system. In women, coral-type stones most often form; they are distinguished by their ability to block the entire renal pelvis. If the pathology was diagnosed only in the later stages, partial removal of the kidney may be required.

The exact causes of the development of the disease could not be established.

The following danger factors are identified that significantly increase the likelihood of urolithiasis:

Insufficient physical activity.
Frequent stressful conditions.
Having excess weight.
Congenital diseases of the urinary system.
Frequent consumption of meat products.
Inflammatory diseases.
Disturbances in metabolic processes.
Genetic predisposition.
Living in an environmentally unfavorable area.

In most cases, the disease develops due to congenital pathologies, as well as in the presence of diseases such as polycystic disease.

Classification of stones

There are several types of kidney stones. They differ from each other in location, shape and quantity.

The following groups of stones are distinguished:

Oxalates. Formation occurs from salts of oxalic acid. By appearance the stone resembles a crystal, the size of which can vary up to quite large. Most often they form in people who abuse sweets and coffee. They can also form due to diabetes mellitus and vitamin B deficiency.
Phosphates. They contain salts of phosphoric acid. Most often diagnosed by X-ray examination. The stones do not injure internal organs, as they have a smooth surface. The main reason their appearance is considered an infectious disease.
Urats. They are distinguished by their ability to be localized in absolutely any part of the urinary system; the location depends on the age of the person. They are formed due to the use of low-quality water and when the metabolic process is disrupted.
Struvite. They can only appear in an alkaline environment during infection. They appear in the presence of certain types of bacteria and in alkaline urine.
Cystine. They are one of the rarest types of stones, most often appearing in people at a young age. The main component is amino acid. They are characterized by severe pain that is not relieved by painkillers.

Set the type of stones is possible only after passing special research. The symptoms of each of them are different, so there is no universal treatment for all categories of stones.

Symptoms of the disease

Urolithiasis (symptoms and treatment in women depend on the causes of the pathology) is manifested by pronounced symptoms, which may differ depending on the type of stones and the stage of pathology.

The following manifestations of the disease are distinguished:

Pain syndrome localized in the abdomen or spine. The pain is intense, periodically intensifies.
The pain may be accompanied by vomiting.
Inability to stay in the same position for a long time.
Urination disorders.
The jet during urination may be interrupted, while the urge itself is preserved.
Bloody traces appear in the urine.
Increased urge to urinate.
General deterioration of well-being, manifested by fever, weakness and chills.

Urolithiasis: causes, symptoms and treatment in women different ways will help you learn everything about the disease.

If at this stage the disease has passed into a neglected form, if left untreated, all of the above symptoms begin to intensify. Against this background, the development of renal failure is also possible.

Renal colic

Renal colic is characterized by debilitating cramping pain.

The following symptoms are identified:

The pain is predominantly characterized in the lumbar region.
The pain syndrome does not decrease from a change in position, and is also poorly relieved by painkillers.
Pain can appear at any time and is sudden.
The attack is not associated with physical or mental stress.

Renal colic can occur for the following reasons:

Genetic predisposition.
Harmful working conditions.
Polycystic kidney disease.
Chronic dehydration.
Stagnation of urine and the presence of inflammatory processes.
High physical activity.

In most cases, renal colic occurs due to urolithiasis.

Hematuria

Hematuria is a process characterized by the presence of blood in the urine.

The symptoms of this condition are as follows:

General weakness.
The appearance of low-grade fever.
The presence of blood in the urine.
Pallor of the skin.
Constant feeling of thirst.

Hematuria has many causes.

These include:

Infectious processes in the genitourinary system.
Mechanical injuries.
States of intoxication, severe poisoning.
Medicines that affect the blood clotting process.
Diseases of an autoimmune nature.
Low blood pressure.

Often, hematuria indicates severe inflammatory processes in the genitourinary system, so if blood is detected in the urine, it is necessary to undergo a diagnostic test.

Coraloid nephrolithiasis

Coral nephrolithiasis is considered an independent disease; it does not belong to the group of other pathologies associated with the formation of stones. Coral-type stones are diagnosed more often than other types. The disease is divided into 4 stages, with the transition to each stage the symptoms worsen.

Initially, the pathology manifests itself as headache, weakness and increased body temperature. As it progresses, the pain syndrome, localized in the lumbar region, intensifies.

The disease develops for the following reasons:

Long-term living in hot climates.
Unbalanced diet, vitamin A deficiency.
Increased protein content in the blood.
Infectious processes in the urinary tract.

In most cases, the disease develops due to a combination of several causes.

Associated infectious processes

Infectious conditions are manifested by the following symptoms:

A sharp increase in body temperature, accompanied by fever.
Weakness, excessive fatigue.
High blood pressure.
The appearance of blood in the urine.
Headache and dizziness.

Infectious processes in the urinary system have several causes of development.

These include:

In some cases, infectious processes develop due to dysfunction of the gastrointestinal tract, as well as due to diseases of the uterus in women.

Diagnosis of urolithiasis

Several methods are used to diagnose kidney stones; a comprehensive examination is necessary to make a diagnosis.

The methods and their characteristics are presented in the table:

General blood and urine analysis.	Laboratory tests can detect the inflammatory process in the body. A urine test allows you to choose the right treatment method, as it determines sensitivity to antibiotics.
Ultrasound	It is a priority examination technique for pregnant women, as it does absolutely no harm. Ultrasound helps determine not only the presence of stones, but also their exact location.
Radiography	An x-ray also allows you to determine the location and size of the stones. Cystine and urate stones are invisible on the image.
CT scan	It is used quite rarely, only when other methods are not informative. Most effective for coral-type stones.
MRI	It is one of the most informative methods, but due to its high cost it is used quite rarely. Helps determine the location, size and type of stones.

In most cases, an accurate diagnosis is made after laboratory tests, ultrasound and x-rays. This diagnostic complex allows you to accurately determine the location of the stone, its type and size.

Treatment of the disease

Urolithiasis (symptoms and treatment in women are individual, they depend on many factors) requires timely treatment.

The following general principles are used in treatment:

It is important to consider that the approach to treatment must be comprehensive. Self-medication is strictly prohibited, all drugs can be used only after the permission of the doctor.

Surgical treatment

Surgical intervention is necessary when urolithiasis is accompanied by complications.

These include:

Pyelonephritis, characterized by inflammation of the kidneys of a chronic nature.
Vivid pain syndrome, which is not stopped by painkillers.
Hydronephrosis.

For removal, traditional, endoscopic and minimally invasive methods are used. Minimally invasive techniques occupy a leading position, as they do not require a long rehabilitation period.

Such an operation is accompanied by a slight loss of blood and almost always passes without complications.

Surgery is the most effective way treatment, as it allows you to completely get rid of stones. To avoid relapse, the patient must follow the recommendations of the doctor.

Pyelolithotomy

This operation allows you to remove stones by dissecting the pelvis of the kidney. It is used when crushing stones is impractical, used for large and numerous stones.

The operation is carried out in the following cases:

With coral-like stones.
For large stones located in the ureter.
For large stones in the renal pelvis.
For stones of a special type and shape that cannot be crushed.

Before surgery, the patient must undergo a series of diagnostic tests. Surgical intervention is not performed for anemia, severe heart disease and any critical conditions.

Nephrolithotomy

The operation is characterized by dissection of the tissues of the pelvis. The intervention is carried out using a nephroscope, which allows a small incision to be made, so the method is minimally invasive.

Has the following indications:

Coral type stones.
Stones that are localized deep in the renal pelvis.
If the stone size is more than 2 cm.
Stones with a branched structure.

The rehabilitation period after surgery does not take a long time. During the first days, patients may experience pain.

Ureterolithotomy

The operation is an invasive technique. Used to remove stones located in the ureteral lumen.

This type of surgery has the following indications:

Disturbances in the outflow of urine, which leads to expansion of the cups.
Pyelonephritis in the acute stage.
Large stones.

The operation requires a careful preparation period. It consists of laboratory tests, ultrasound, and in some cases an MRI may be required. After surgery, the patient must wear a special drainage and also avoid excessive activity and heavy lifting. They are discharged from the hospital no earlier than after 2 days.

X-ray endoscopic operations

The technique allows you to remove stones of various structures and sizes. Conducted under general anesthesia or under spinal anesthesia. All manipulations are carried out using a special camera, which allows you to see all the smallest details on the screen. Removal is carried out with a high-precision laser.

The indications are as follows:

Stones of coral type.
The appearance of renal colic.
Urine outflow disorders.
Acute pain in the kidney area.
Acute pyelonephritis.

Distinctive feature this method is rapid rehabilitation. After 4-5 hours the patient can leave the hospital.

Shock wave lithotripsy

This technique does not involve surgical intervention, since the destruction of stones occurs under the influence of shock waves.

Used in the following conditions:

Difficulty in urinating.
Pain localized in the kidney area.
The stones available are large in size.
Multiple stones.

This manipulation is prohibited for pregnant women, as well as for acute diseases of the urinary system.

Conservative treatment

Conservative treatment involves the use of methods without surgery. It is carried out in cases where the stones are small in size and the pain syndrome can be relieved with painkillers.

Conservative treatment eliminates the symptoms of the disease and promotes the passage of stones in the urine.

In addition to medications, conservative methods include herbal medicine, diet and special physical exercises.

Antibiotics

Urolithiasis is almost always accompanied by an inflammatory process; symptoms and treatment in women depend on the stage of inflammation.

Antibiotics are most effective in the initial stages of pathology; they can be administered intravenously or taken orally. The course of treatment should not exceed 14 days. In order to choose the right drug, you need to take a blood and urine test.

The most commonly used drugs are:

It is worth considering that only a doctor can prescribe antibiotics; self-medication is not acceptable.

Drugs to lower uric acid levels

This group of drugs not only reduces uric acid levels, but also improves the patient's condition.

Febuxostat. Recommended for long term use. The first results become noticeable after 2 months. Prohibited in severe liver disease.
Probenecid. Removes salt crystals from the kidneys. Take 1-2 tablets per day. The course of treatment is selected individually.
Allopurinol. Take 1 tablet up to 4 times a day. The course of treatment depends on the severity of the disease.

Patients should note that all of the above drugs are prohibited for women during pregnancy.

Antispasmodics

Antispasmodics eliminate pain by relaxing smooth muscles and are most effective in the initial stages of the disease.

No-Shpa. A single dosage should not exceed 2 tablets; you are allowed to drink up to 240 mg per day. Without consulting a doctor, take no more than 2 days.
Bencyclane. Allowed during pregnancy, but with caution. Take up to 4 tablets per day.
Spasmalgon. The maximum dose is 4 tablets per day. Injections are used for acute renal colic.

Contraindications for each drug are different, so before use you must carefully read the instructions.

Painkillers

This group includes the following drugs:

Pentalgin. Take 1 piece, the maximum dose is 4 tablets. Use is allowed for no more than 5 days.
Nurofen. Drinking after meals is allowed with milk. The break between uses should be at least 4 hours. The maximum dosage is 4 tablets.
Diclofenac. It is an injection; the therapeutic dose should not exceed 1 ampoule per day.

Painkillers should not be taken for a long time, as they negatively affect the condition of the entire body, in particular the kidneys.

Diuretics

Diuretics can only be used for small stones.

This group includes:

Indapamide. Take 1 tablet per day. Mostly in the morning on an empty stomach. The course is selected individually.
Klopamide. Start taking with 20 mg per day, if necessary, increase the dose to 40 mg per day.
Arifon. Take in the morning, the initial dosage is 1.25 mg. If necessary, increase to 2.5 mg.

Diuretics must be taken in strict accordance with the course of therapy prescribed by the doctor. Prolonged use can aggravate the situation.

Preparations for dissolving urinary stones

They are used in the absence of complications and with small stones.

This group includes:

Drugs for dissolving stones are effective only in the initial stages of the disease; their use in the future is not advisable.

Cheap drugs for the treatment of urolithiasis

List of medicines in the table:

A drug	Action	Price
Drotaverine	A drug from the group of antispasmodics. Relaxes smooth muscles, thereby achieving an analgesic effect. Recommended on early stages diseases.	60 rub.
Furagin	It has an anti-inflammatory effect, as well as a mild diuretic effect. It is used for any infectious processes in the urinary tract.	75 rub.
Canephron	It has anti-inflammatory, antispasmodic and antibacterial effects. It contains only natural ingredients, so the drug does not cause side effects.	250 rub.
Uronephron	Used to dissolve kidney stones. Allowed only if the stones are small. The drug is also aimed at normalizing metabolic processes.	100 rub.

Phytotherapy

Urolithiasis (symptoms and treatment in women depend on many factors that must be taken into account when selecting therapy) in some cases can be treated with herbal medicine. It is important to consider that this method is effective only in the early stages, while herbal medicine is used as an additional remedy.

Herbal infusions eliminate the inflammatory process in the urinary system, reduce the size of stones, and also help relieve pain.

Rose hip

Rose hips normalize the functioning of the urinary system. Due to its high content of vitamin C, it increases the body's protective functions.

Grind 50 g of rose hips, then pour 200 ml of water into it.
Put on fire and cook for 20 minutes.
Strain the broth thoroughly.

Take 2-3 sips before meals, the course of treatment should be at least 1 month.

Barberry

Barberry has the ability to dissolve kidney stones and reduce their size. It also has a slight antispasmodic effect.

The manufacturing recipe is as follows:

Finely chop 100 g of barberry, pour it with 2 glasses of water.
Place on low heat for 30 minutes.
Let sit until completely cooled and mix thoroughly.

Use the resulting composition 1 tsp. 2-3 times a day.

knotweed

With regular use, it normalizes salt metabolism in the body and also promotes the passage of kidney stones. Dissolves stones, which reduces their size. Recommended not only for treatment, but also as a prevention of urolithiasis. Has antimicrobial and diuretic effects.

For kidney stones, use the following tincture:

Grind the knotweed herb.
Fill it with water, the mass should be liquid.
Put on fire and boil for 30 minutes.
Leave in a dark place for 2 hours.

Drink 50 ml daily, 2 times a day. The recommended course of therapy is 14 days.

Grape

White grape juice is used as a diuretic. Doctors recommend that people suffering from kidney disease include grapes in their diet.

The following recipe is effective in the initial stages of the disease:

Wash and dry 200 g of grape leaves, then chop.
Pour 1000 ml of clean cool water.
Leave to infuse in a dark place for 3 days.
Strain thoroughly.

Use 50 ml daily. This recipe is not effective for large stones.

Chamomile

Chamomile is known as an anti-inflammatory agent. In the treatment of urolithiasis, it is used as part of medicinal preparations, as well as as an independent remedy. Due to its mild antispasmodic effect, chamomile helps relieve pain.

The decoction recipe is as follows:

Finely chop 100 g of chamomile, pour a glass of hot water.
Put on fire for 20 minutes.
Leave to brew for 2 hours.

Drink 50 ml daily 3 times a day. It is recommended to drink before meals.

Herbal infusions

Plantain. It has antiseptic properties and is most effective for coral-type stones.
Cranberry. It has an anti-inflammatory effect, but in case of urolithiasis it is allowed in small quantities.
Birch buds. They remove excess fluid and alleviate the general condition of urolithiasis.
Yarrow. Relieves pain and facilitates the movement of stones.

A competent combination of components will help increase the effectiveness of therapy.

Diet for urolithiasis

Diet for kidney stones does not require serious restrictions.

Several principles must be followed in nutrition:

Drinking enough liquid.
The diet should be varied and balanced.
It is necessary to give up spices and reduce the use of salt as much as possible.
You need to reduce the portion size.
Avoid foods that contribute to the formation of kidney stones (such as fatty meats, fish and legumes).
Completely give up alcoholic beverages.

Patients should note that fasting is strictly contraindicated, as this can significantly aggravate the situation. It is recommended to eat food 4-5 times a day, but in small portions. The emphasis in nutrition is desirable to do on fresh vegetables and fruits.

Drinking regimen and "water strokes"

The so-called “water shock” technique is permissible only in the initial stages of the disease. Its essence is that in the morning you need to drink 1.5 liters of liquid within 10 minutes. It doesn't have to be pure water. It is allowed to use an infusion of herbs or fresh juice. It is also possible to use a watermelon as a “water blow”.

Before using this method in treatment, it is necessary to undergo an ultrasound scan, since stones larger than 10 mm are a contraindication. The break between such procedures should be days.

Therapeutic exercises for women with urolithiasis

Exercise therapy for urolithiasis is allowed only during the period of remission. In this case, the lesson should not last more than 30 minutes, the load must be moderate. Do not use weights during exercise.

Therapeutic gymnastics has the following functions:

Helps remove kidney stones.
Helps normalize renal excretory function.
Normalizes metabolic processes.
Reduces the severity of pain.

Contraindications:

State of fever.
Acute period of the disease.
Localization of the stone in the pelvis apparatus.
Kidney failure.
Infectious diseases.

Exercises are selected individually by the doctor in each case; they depend on the stage of the disease, age and general condition of the woman. Particular emphasis is placed on bending and twisting, and it is recommended to exclude swings and jumps.

How to relieve an attack at home

In order to relieve an attack at home, you must perform the following steps:

It is strictly forbidden to take painkillers in large quantities, it is also necessary to avoid overheating of the lower back. If the attack does not recede, then you will need to call an ambulance brigade.

Urolithiasis progresses quite quickly, the symptoms and treatment in women depend on the stage of the pathology. An acute attack indicates complications of the disease and requires immediate medical attention.

Article format: Lozinsky Oleg

Video about urolithiasis

What is urolithiasis, symptoms and treatment:

Pathological processes in the kidneys are diagnosed more and more often with age. When the first symptoms of urolithiasis appear, it is very important to contact a urologist who will be able to choose the right drugs for the treatment of urolithiasis. With the help of drug therapy, it is possible to prevent dangerous consequences and complications of the disease.

General information

Urologists identified infectious and non-infectious pathologies of the kidneys. Processes of an infectious nature develop as a result of the introduction of infectious agents in an ascending way, they are the result of cystitis, urethritis and other diseases. They can also develop due to infections in other organs, while moving to the kidneys along with the bloodstream. More often, a woman suffers from such diseases; in a man, complications and a severe course of microbial cb are mainly diagnosed.

Medicines for urolithiasis are selected depending on the source of infection and the type of pathogen, the duration of the pathological process and the severity of symptoms.

The main goals of therapeutic intervention are:

getting rid of the cause of the disease - eliminating the inflammatory process, dissolving and removing sand and stones;
eliminating the severity of clinical manifestations so that the kidney restores its functions;
prevention of the occurrence of diseases in the future (immune-strengthening therapy, vitamin therapy).

Antibiotics

An antibiotic for urolithiasis is necessary in order to achieve maximum effectiveness from the therapeutic effect. Antibiotics used in treatment should have the following properties:

antimicrobial activity against pathogens;
eliminating barriers to microbial resistance;
creation of active components in urine and blood fluid.

Antibacterial drugs used in therapy are divided into several main categories. They are prescribed by urologists, taking into account the provoking factor in the development of the disease and the stage of its development. The fluoroquinolone category is represented by the following drugs: Ciprofloxacin, Levofloxacin, Maxifloxacin. Another category of drugs are sulfonamides: Biseptol, Sulfadimezin. The group of nitrofurans includes: Furadonin, Furamag. Aminopenicillins include: Ampicillin, Amoxiclav.
Currently, urologists less frequently prescribe aminopenicillins, nitrofurans and tetracyclines, since pathogens quickly develop resistance to them. All dosages and duration of therapy are prescribed only by the attending physician, taking into account the severity of the disease and the severity of symptoms. Long-term use of an antibiotic can cause pathogens to become resistant to it.

Stone-dissolving drugs

Urolithiasis is also treated with the help of medications to dissolve kidney stones. These medications, citrates, reduce the acidity of urine. If on high level Maintain the acid-base balance in the body for a long time, this helps the stones gradually dissolve. The duration of medication is determined by the diameter of the stones; on average, therapy lasts at least three months (in some cases up to seven months).

Stone-dissolving agents are also used to prevent further formation of sand or stones. At the same time, you should monitor how the stones dissolve using ultrasound, radiography, and computed tomography. When carrying out therapy, it is necessary to drink plenty of fluids - more than two liters during the day, it is also important to observe proper nutrition(exclude fried, fatty, salty, spicy foods).
The following drugs belong to the category of citrates: Tiopronin, Biliurin, Blemaren. Blemaren is an effervescent tablet or granular powder. It contains potassium or sodium citrates. This drug dissolves stones, regardless of their type. Dimensions - no more than three millimeters. Otherwise, a radical solution to the problem is indicated.

Antispasmodics

To cure the kidneys from urolithiasis, myotropic or neurotropic drugs are additionally used. With their help, a relaxing effect on the smooth muscles of the urinary canals is carried out, against the background of this, their function is restored. Antispasmodics are also used if renal colic worsens. With the help of antispasmodic drugs you can achieve the following results:

improve the microcirculation of the blood fluid, as the vessels dilate after the use of drugs;
remove hidden swelling from tissues;
expand the lumen of the urinary tract, so that the stones will be removed quickly and painlessly.

Neurotropic drugs prevent spasm of smooth muscles and the appearance of discomfort, as they suppress nerve impulses that stimulate the contraction of smooth muscle tissues. These drugs include: Platiphylline, Scopolamine.

Myotropic agents have a relaxing effect on muscle fibers, due to this, spasm is relieved. The action of such drugs on average lasts no more than three hours, so they are prescribed two or three times a day. The most common medications in this category are: No-shpa, Papaverine, Eufillin, Dibazol. Urolithiasis is often treated with No-shpa; it is a safe medication for the body and works quickly. Urologists prescribe myotropic drugs for acute urolithiasis in the form of droppers for intravenous administration morning and evening, so it will quickly relieve pain.
An effective drug is Tamsulosin. It reduces muscle tone and improves detrusor function. It is prescribed once a day. Do not use in case of severe liver diseases or in the presence of hypertension. For renal colic, which is accompanied by urolithiasis, analgesics and antispasmodics are used: Maxigan, Spasmalgon, Trigan. One tablet is prescribed twice a day.

Diuretics

A diuretic medication is necessary in order to restore normal liver function, quickly remove pathogens, and remove stones during exacerbation of urolithiasis. Diuretics vary in their mode of action. The most common are: Furosemide, Torasemide, Diuver. But more often, urologists prefer to prescribe diuretics of herbal origin. Medicinal plants have a mild effect, they are safe, there are no adverse reactions. Most often they contain: Bearberry, corn silk, birch buds.
Herbal infusions with the listed herbs not only have diuretic properties, but are also antiseptic. They are prescribed in courses of 14 days, after which they take a break of a month and take them again. Kidney tea has a mild diuretic effect.

Painkillers

Analgesics that are used to treat urolithiasis belong to the category of alkanoic acids or to the group of non-steroidal anti-inflammatory drugs. They relieve pain and eliminate inflammation. The drugs in the group of non-steroidal anti-inflammatory drugs include: Diclofenac, Indomethacin, Ibuprofen.
Such medications can be used for a long time. Baralgin is considered another effective drug for treating urolithiasis. It relieves pain and dilates blood vessels. Urologists prescribe it more often than other drugs.

Herbal medicines

When prescribing therapy, doctors additionally recommend the use of herbal medicines. They help cure diseases and prevent their exacerbations in the future. The most popular among this category are: Canephron, Cyston, Urolesan, Gentos, Fitolizin.
Kanefron is an effective anti-inflammatory, diuretic and antispasmodic drug. With its help, stone crushing occurs faster. Only such a therapeutic effect occurs after long-term use facilities. It also restores kidney function, relieves pain, relieves the inflammatory process. After starting therapy, a person feels relief within a few days. The composition of Kanefron contains such plants: Rosemary, Centaury, Lovage. The anti-inflammatory drug is produced in the form of tablets (for patients over the age of seven), drops (for patients under the age of 7). The duration of treatment is 60 days.
Cyston – contains in the base medicinal plants and mumiyo. It has a bactericidal property, increases the body's natural defenses, prevents the formation of stones. Often prescribed during treatment with antibacterial drugs. Can be used as a preventative medicine. Recommended doses are two units in the morning and evening.

Nephroleptin is a modern medicine for urolithiasis. It is based on: Propolis, Licorice root, Bear's Ears, Lingonberry leaves, grass of the bird Highlander. Has the following properties:

diuretic;
anti-inflammatory;
restorative.

Since the composition contains the listed active components, the medicine is prescribed with caution in childhood and during pregnancy. The duration of therapy is at least three weeks.
In terms of its properties, it is identical to the above drugs, only its release form is a paste, it contains the following medicinal plants:

Horsetail;
onion peel;
Fenugreek;
Parsley;
Wheatgrass;
avian Highlander;
Lovage.

It also contains essential extracts and pine oil. A teaspoon of paste is stirred in a glass of slightly warmed water. To achieve a lasting effect, you need to take Phytolysin for two months. With its help, both therapy and prevention of pathological processes in the organs of the urinary system are carried out.
All herbal remedies are not intended as a stand-alone treatment for any kidney disease. They must be taken with other medications prescribed by your doctor. In each specific case, a different treatment regimen is prescribed; all prescriptions are carried out only after preliminary diagnosis.
It is also important to take measures to strengthen the body's immune system. For this, doctors prescribe immunomodulatory medications, multivitamin complexes, which also contain trace elements (calcium, potassium, sodium). This way, the body’s natural protective functions will better resist infectious and viral agents that can cause inflammatory processes in the organs of the urinary system. To prevent the formation of stones and sand in the kidneys, proper nutrition and adherence to the drinking regime are important.

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Antibiotics and anti-inflammatory drugs

Fluoroquinolones

The fluoroquinolones group are drugs that have been used since the 60s. The difference from other antibacterial agents is the effect on highly drug-resistant strains of microorganisms. Their principle of operation is based on changing and blocking the DNA of bacteria. Medicines from the fluoroquinolones group, widely used for urolithiasis, are:

"Ofloxacin" has a negative effect on microbial cells, preventing them from dividing, which leads to the death of the bacterium. It has a number of contraindications. Prohibited for use by pregnant and lactating women, as well as children. This is associated with many adverse reactions.
Lomefloxacin is a broad-spectrum antimicrobial drug. Its substances are integrated into the DNA of the microorganism and destroy cells from the inside. The product is effective for diseases of the urinary system, including the presence of stones. The dosage is calculated by the doctor based on test results and the course of the disease. Prohibited during pregnancy and during breastfeeding, as well as persons under 18 years of age.

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Cephalosporins

Cephalosporins represent the most extensive group of drugs in terms of the number of drugs. Their action is aimed at creating disturbances in the structure of the bacterial cell wall. Low toxicity and high results have led to the frequent use of these antibiotics in medicine. Medicines for urolithiasis from the cephalosporin group:

"Ceftazidime" is a drug of the 3rd generation. Effective for severe infections when the underlying cause is unknown. Injections are allowed for children from birth. Before prescribing, pregnant and lactating women should weigh the possible consequences.
"Cefepim" refers to the funds of the IV generation. It has an effect on almost all types of bacteria. If the causative agent of the disease is not identified, then the Cefepime injection is recommended as a universal drug, including for urolithiasis. In pediatrics, use begins at 2 months. Pregnant women are prescribed the drug under the condition of careful monitoring.

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Aminoglycosides

The aminoglycoside group was discovered in the 1940s. The mechanism of action of medications is a targeted disruption of protein synthesis in microorganisms. The downside is the relatively small list of susceptible bacteria. Treatment of urolithiasis is carried out with the following drugs:

Amikacin has many indications for use, including stones in the genitourinary system. Before starting use, you should determine the reaction of the pathogen to the antibiotic. The dosage and number of doses is determined by the attending physician. The drug is administered intramuscularly. Used in pediatrics to treat newborns and premature babies, the body's reaction should be carefully monitored. Contraindicated for liver problems.
"Gentamicin" is active against many bacteria, therefore it is widely used for therapeutic purposes. Available in powder form for dilution and further administration into a muscle or vein. In pediatrics it is used only in severe cases.

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Carbapenems

The active ingredients of drugs belonging to the carbapenem group destroy the cell walls of bacteria, which leads to their death. This effect contributes to an active influence on many types of microorganisms. Effective pharmacotherapy for urolithiasis with carbapenems includes:

Meropenem is prescribed for a number of diseases caused by bacteria. Used by injection into a vein. It is prohibited for use by children under 3 months, pregnant and lactating women. Prescribe with caution to people with gastrointestinal problems. The dose is calculated by the attending physician.
The combination “Imipenem” + “Cilastatin” is prescribed for a number of infectious diseases. Prohibited for use by people with liver problems, pregnant and nursing mothers, and children under 3 months. Available in powder form for preparation of a solution and further administration into a vein using a dropper.

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Anti-inflammatory nonsteroidal drugs

Non-steroidal anti-inflammatory drugs have the ability to reduce pain, body temperature, relieve inflammation and fever. The advantage of their use is the minimum of negative reactions from the body. If there are stones in the organs, it makes sense to prescribe them to combat the resulting inflammation. The most famous are:

Diclofenac is an analgesic and anti-inflammatory drug. It also has the property of lowering body temperature. Contraindicated for disorders of the gastrointestinal tract. Your doctor will help determine the dosage and duration of use.
"Ketoprofen" has the effects inherent in anti-inflammatory non-steroidal drugs, including painkillers. It has several release forms, which helps to correctly calculate and use the prescribed dose. Prohibited when carrying a child and during breastfeeding.

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Diuretics

The main function of the kidneys is to process and remove excess fluid and salts of harmful substances from the body. It is swelling that becomes the first symptom of a malfunction of the organ. Diuretics for kidney stones can only be prescribed by the attending physician, provided that the formations are small in size. For correct and effective treatment diuretics should determine the nature of the stones. Thus, for formations of calcium and phosphate types, potassium-sparing diuretics or infusions of medicinal plants will be effective. Thiazide diuretics are used to treat oxalate stones. In addition to the nature of the stones, an important factor is the general health and stage of the disease. In the initial stages, good results can be achieved by consuming foods with diuretic properties.

What should I take from preparations containing herbal ingredients?

Synthetic drugs for urolithiasis show good results and are among the most effective. However, along with this, they have many contraindications and negative consequences for the body. Analogues of such medicines are products based on herbal components. When using them, good results are observed with a minimum of adverse reactions. The advantages of such drugs include permission for use by children and pregnant women. Negative side their is a possible intolerance to the herbs and plants that are included in the composition. Therefore, it is recommended to consult a doctor before use.

Canephron tablets consist of a combination of medicinal plants that effectively fight inflammatory processes in the genitourinary system. When diagnosed with urolithiasis, the drug is prescribed to remove crushed stones and sand. In addition to the anti-inflammatory effect, the tablets help relieve muscle spasms and remove excess fluid from the body. "Canephron" is prescribed as an independent medicine or as an adjunct to general therapy. The dosage and frequency of administration are determined by the attending physician based on laboratory tests and general medical history. The maximum daily dose is 6 tablets for adults and 3 for children over 10 years of age. Due to the herbal composition, these tablets for urolithiasis are prescribed to pregnant and lactating women. Patients with diabetes mellitus should take it with caution.

"Cyston" for urolithiasis

"Cyston" belongs to a group of drugs with antiseptic properties. In addition, its effectiveness has been proven in removing stones and sand from the genitourinary system. Used as an adjunct to primary therapy for infectious diseases. The completely natural composition of the medication explains the absence of contraindications to it. However, before taking it, you should make sure that you are not allergic to its ingredients. Otherwise, itching, spots and rashes on the skin may occur. The average dosage for an adult is 2 tablets 2-3 times a day. Children under 18 years of age can use the product only under the supervision of a pediatrician.

The drug has diuretic, analgesic and anti-inflammatory properties. It is used as a medicine for the treatment of urolithiasis. Contraindications are kidney problems and stomach ulcers. Available in the form of drops, which are applied to a piece of sugar before use. The dosage is calculated by the attending physician; on average, it is 3-4 drops during remission and up to 10 during an attack. With the approval of a doctor, the drug is approved for pregnant and lactating women.

"Enatin" for the treatment of urolithiasis

The drug has a combined effect, helps relieve the inflammatory process, improves the release of bile and excess fluid, and also relieves muscle spasms. Effective for the treatment and prevention of urolithiasis. It is prohibited to prescribe medication for peptic ulcer, problems with urination and impaired kidney function. Release form: capsules, taken up to 5 times a day before meals. To prevent illness, 1 pill per day is enough.

“Phytolysin” has antimicrobial, antispasmodic, anti-inflammatory and other effects on the body. The herbal components included in the preparations effectively fight stones and sand in the organs of the genitourinary system, therefore the product is prescribed as a medicine for urolithiasis of the kidneys. The medication has a number of contraindications, the implementation of which will minimize adverse reactions. “Fitolysin” is produced in the form of a paste, which is diluted in water at room temperature immediately before use. If desired, you can add honey or other sweetener. The drug is used in pediatrics, even for newborns. Self-use of the product is unacceptable, as it can lead to negative reactions in the body.

"Avisan" - a drug for stones

The product is intended to relieve muscle spasms. Thanks to the composition, it promotes the movement of stones and their easy exit. Contraindications include problems with the cardiovascular system and individual intolerance to the components. Possible side symptoms include indigestion, but this is not a reason to discontinue the drug. The correct dosage and duration of use is determined by the attending physician.

The drug has properties aimed at removing stones from the genitourinary system. Along with taking Artemizol, it is recommended to follow a diet for urolithiasis. The release form is drops, which are applied to a piece of sugar before taking. The average duration of treatment is up to 20 days. The exact dosage and time of administration are determined by the attending physician.

Pathological processes in the kidneys are diagnosed more and more often with age. When the first symptoms of urolithiasis appear, it is very important to contact a urologist who will be able to choose the right drugs for the treatment of urolithiasis. With the help of drug therapy, it is possible to prevent the dangerous consequences and complications of the disease.

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General information

Medicines for urolithiasis are selected depending on the source of infection and the type of pathogen, the duration of the pathological process and the severity of symptoms.

The main goals of therapeutic intervention are:

getting rid of the cause of the disease - eliminating the inflammatory process, dissolving and removing sand and stones;
eliminating the severity of clinical manifestations so that the kidney restores its functions;
prevention of the occurrence of diseases in the future (immune-strengthening therapy, vitamin therapy).

Antibiotics

An antibiotic for urolithiasis is necessary in order to achieve maximum effectiveness from the therapeutic effect. Antibiotics used in treatment should have the following properties:

antimicrobial activity against pathogens;
eliminating barriers to microbial resistance;
creation of active components in urine and blood fluid.

Stone-dissolving drugs

Urolithiasis is also treated with the help of medications to dissolve kidney stones. These medications, citrates, reduce the acidity of urine. If you maintain the acid-base balance in the body at a high level for a long time, this helps the stones gradually dissolve. The duration of medication is determined by the diameter of the stones; on average, therapy lasts at least three months (in some cases up to seven months).

Stone-dissolving agents are also used to prevent further formation of sand or stones. At the same time, you should monitor how the stones dissolve using ultrasound, radiography, and computed tomography. When carrying out therapy, it is necessary to drink plenty of fluids - more than two liters during the day; it is also important to maintain proper nutrition (exclude fried, fatty, salty, spicy foods).
The following drugs belong to the category of citrates: Tiopronin, Biliurin, Blemaren. Blemaren is an effervescent tablet or granular powder. It contains potassium or sodium citrates. This drug dissolves stones, regardless of their type. Dimensions - no more than three millimeters. Otherwise, a radical solution to the problem is indicated.

Antispasmodics

improve the microcirculation of the blood fluid, as the vessels dilate after the use of drugs;
remove hidden swelling from tissues;
expand the lumen of the urinary tract, so that the stones will be removed quickly and painlessly.

Myotropic agents have a relaxing effect on muscle fibers, due to this, spasm is relieved. The action of such drugs on average lasts no more than three hours, so they are prescribed two or three times a day. The most common medications in this category are: No-shpa, Papaverine, Eufillin, Dibazol. Urolithiasis is often treated with No-shpa; it is a safe medication for the body and works quickly. Urologists prescribe myotropic drugs for acute urolithiasis in the form of intravenous droppers in the morning and evening, so they will quickly relieve pain.
An effective drug is Tamsulosin. It reduces muscle tone and improves detrusor function. It is prescribed once a day. Do not use in case of severe liver diseases or in the presence of hypertension. For renal colic, which is accompanied by urolithiasis, analgesics and antispasmodics are used: Maxigan, Spasmalgon, Trigan. One tablet is prescribed twice a day.

Diuretics

Painkillers

Herbal medicines

When prescribing therapy, doctors additionally recommend the use of herbal medicines. They help cure diseases and prevent their exacerbations in the future. The most popular among this category are: Canephron, Cyston, Urolesan, Gentos, Fitolizin.
Kanefron is an effective anti-inflammatory, diuretic and antispasmodic drug. With its help, stone crushing occurs faster. Only such a therapeutic effect occurs after prolonged use of the product. It also restores kidney function, relieves pain, relieves the inflammatory process. After starting therapy, a person feels relief within a few days. The composition of Kanefron contains such plants: Rosemary, Centaury, Lovage. The anti-inflammatory drug is produced in the form of tablets (for patients over the age of seven), drops (for patients under the age of 7). The duration of treatment is 60 days.
Cyston – the base contains medicinal plants and mumiyo. It has a bactericidal property, increases the body's natural defenses, prevents the formation of stones. Often prescribed during treatment with antibacterial drugs. Can be used as a preventative medicine. Recommended doses are two units in the morning and evening.

Nephroleptin is a modern medicine for urolithiasis. It is based on: Propolis, Licorice root, Bear's Ears, Lingonberry leaves, grass of the bird Highlander. Has the following properties:

diuretic;
anti-inflammatory;
restorative.

Horsetail;
onion peel;
Fenugreek;
Parsley;
Wheatgrass;
avian Highlander;
Lovage.

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The question of how to treat urolithiasis is dealt with not only by urological doctors, but also by surgeons who surgically remove stones from different parts of the urinary tract.

Unfortunately, no doctor can guarantee a patient a complete recovery, even if the treatment met all modern standards. If metabolic failures have occurred in the patient’s body and the process of stone formation has been started, then there is a constant threat of their new formation.

In order to avoid this, treatment of urolithiasis should be multidirectional and combined, which will ensure an impact on all links in the pathogenesis of the disease, especially in people at risk of relapse of the process.

Medical nutrition

According to the protocol for the management of a patient with urolithiasis, treatment measures begin with prescribing an appropriate dietary option. Thanks to therapeutic nutrition, you can stop the formation of new stones, as well as speed up the process of breaking down already formed stones.

The diet for urate urolithiasis is aimed at “alkalinizing” the urinary sediment. To do this, it is necessary to include fresh vegetables and fruits, berries and all dairy products in the patient’s diet.

At the same time, the consumption of fish and meat dishes, especially those prepared from fatty varieties, alcohol, champignons, spinach, offal, legumes, semi-finished products, eggs (that is, those products that contain an excess of purine bases) is sharply limited.

The volume of liquid drunk during the day should not be less than 2-2.5 liters. It is not recommended to drink drinks made from cranberries and lingonberries, as they can increase the acidity of urinary sediment.

A diet for oxalate urolithiasis implies the complete exclusion from the patient’s diet of products containing oxalic acid or substances that can serve as a source for its synthesis.

Completely excluded following products: spinach, rhubarb, sorrel, offal, fatty meats, mushrooms, chocolate products, coffee, cocoa, smoked snacks, pickles and others.

At the same time, a sufficient amount of magnesium and potassium must be present in the diet. The diet includes cereals (pearl barley, oatmeal and buckwheat), hard-ground bread, rye bran, dried fruits, etc.

The following products are allowed: boiled fish and lean meats that are steamed or boiled, eggs, dairy products, vegetables and fruits that do not contain oxalic acid (cucumbers, pumpkin, bananas, apricots and others).

The diet for phosphorus-calcium urolithiasis is aimed at “acidifying” the urine, which speeds up the process of removing stones from the body and prevents the precipitation of salt crystals into the urinary sediment.

The following products are excluded or maximally limited in consumption: milk and dairy products, potatoes, vegetable salads, spices, compotes and fruit preserves, etc.

It is recommended to consume fish and meat of low-fat varieties, vegetable fats, cereals without adding milk, bread products, vegetables (pumpkin, peas, mushrooms) and fruits (sour varieties of apples, lingonberries, cranberries and compotes made from them), weak tea, etc. d.

The volume of water load per day should not be less than 3 liters. It is recommended to use fruit drinks and compotes from cranberries and lingonberries daily to speed up the process of changing the pH of urine to the acid side.

Drug therapy

Symptomatic treatment is necessary for relief pain, which arise due to muscle spasm, when the calculus moves along the lumen of the ureter.

For these purposes, the following drugs are used, which are administered intramuscularly or intravenously:

No-spa 2% -2 ml;
Papaverine 2% -2 ml;
Analgin 50% -2 ml;
Tramadol 1% -1 ml and others.

After an attack of renal colic is stopped, their further use in tablet form is allowed.

Among the most common painkillers used to treat an attack of renal colic due to urolithiasis, it is worth highlighting Baralgin. It is prescribed either alone or in combination with the drugs described above, which speeds up the process of pain relief.

In Russia, novocaine blockades (paravesical, suprapubic, paravertebral, paranephric and others) have found their use.

Pathogenetic treatment is decisive in the direct fight against the process of stone formation.

To prevent the synthesis of stones from uric acid (urates), Allopurinol tablets are used at a dose of 300 mg (100 mg 3 times a day) for a course of 2-3 weeks (under monitoring the level of uric acid in the patient’s body).

Accelerates the process of excretion of urates by the kidneys Butadione (0.1 g 4-6 times a day for 3-5 weeks).

To start the process of breaking down stones of urate origin, citrate mixtures are used, which include several components: sodium citrate, potassium citrate, ascorbic acid. The resulting solution is taken for several months with mandatory monitoring of urine pH. Instead of the citrate mixture, the patient can be prescribed Uralit (combined drug).

Oxalaturia is eliminated by taking Allopurinol and drugs that include magnesium oxide, B vitamins (in particular B6) and A (retinol).

For urolithiasis associated with calcium metabolism disorders, medications are prescribed that can reduce its concentration by binding and forming insoluble compounds. For this purpose, Almagel is prescribed for 2 tsp. 3-4 times a day for 2-3 weeks.

Flurbiprofen accelerates the process of excretion of free calcium, which prevents its precipitation into crystalline compounds. Its dose is 0.05 g 3 times a day.

The level of phosphates in the patient's blood is reduced by the appointment of vitamin D2 (200-400 IU). Treatment is also carried out with Xidofon (1 tbsp. L. 3 times a day). The course of treatment is chosen individually.

To eliminate pain and other manifestations of urolithiasis at home, combined drugs are used, such as Cystenal, Spasmocystenal, Canephron, Cyston and others.

When an infectious agent is attached and the inflammatory process begins, treatment is carried out with broad-spectrum antibacterial drugs and antimicrobial agents.

Phytotherapy

In addition to conservative treatment methods, a significant role in the treatment of patients with in different forms urolithiasis is given to the use of herbal remedies. When properly combined with each other, they have effects that are not inferior to synthetic drugs.

Herbal infusions help in the fight against inflammation, the spastic component of the disease, change the pH of urine, and also have a bactericidal effect.

To dissolve oxalate stones, use nettle juice (2 tablespoons 3 times a day for a month).

Urate urolithiasis can be treated with an infusion of birch leaves. To do this, take 3 tbsp. l. dry substrate, pour 300 ml boiled water and leave for 3-4 hours, after which they take 100 ml 3 times a day (course of therapy is 30-40 days).

Stones of a phosphate nature will help to dissolve a decoction, which contains the following components: bean pods, corn silk, bearberry leaves, blueberry leaves. It is necessary to pour 1 tablespoon of the collection with 300 ml of boiling water, leave for 2-3 hours, strain and take 1 spoon 3 times a day.

To speed up the spontaneous passage of stones, a collection is prescribed, which includes horsetail herb, bearberry leaf, lingonberry and birch leaves, juniper fruits and licorice root.

Surgical treatment

If the stone does not manifest itself clinically, the patient does not make any complaints, and its discovery is an accidental finding, then treatment of urolithiasis continues with conservative methods. Most often, we are talking about a single formation of small size, located in one of the calyces of the kidneys, and there should be no disturbances in the functions of the organ.

Not all stones can pass out on their own, even if their size does not exceed 5-6 mm. The reason for this may be obstructive disorders in the urinary tract, the presence of inflammatory changes that impede the passage of stones, etc. In any of these cases, surgical intervention is necessary, due to which the formed calculus will be completely removed or crushed into smaller parts.

External shock wave lithotripsy

With implementation modern methods Thanks to minimally invasive surgery, the treatment of urolithiasis has become as safe and more effective as possible.

Currently, the method of remote shock wave lithotripsy (ESWL) is widely used, the essence of which is to create a special wave pulse with a device that can crush the stone into smaller parts. In the future, they are independently washed out of the urinary tract.

If the size of the stone exceeds 2 cm, then, before performing DLT, the patient is given a special catheter, with the help of which all its destroyed fragments are removed. This is necessary in order to avoid their accumulation in the ureter, which will lead to another attack of renal colic, and can also cause complications.

In order for the procedure to have maximum effect and have the least traumatic effect on surrounding tissues, it must be carried out under mandatory ultrasound or x-ray control. The shock wave should only affect the area in which the stone is located.

Contraindications to the treatment of urolithiasis using DLT:

obesity in a patient of varying severity or severe deformation of bone structures (it is impossible to accurately determine the focus of the shock wave);
diseases of the blood coagulation system, severe heart or lung diseases;
inflammatory processes in the organs of the urinary system (acute pyelonephritis, cystitis and others);
deformations of the ureter below the location of the stone (scars, strictures);
impaired glomerular filtration of the kidneys (more than 50% of the initial values);
acute processes in the gastrointestinal tract (pancreatitis, cholecystitis and others).

Transurethral endoscopic lithotripsy and lithoextraction

Thanks to this type of surgery, it is possible not only to destroy the stone into smaller pieces, but also to remove its remains and restore the obstruction of the ureter, if necessary.

Thanks to an endoscope inserted into the lumen of the urethra, it is possible to visualize and remove the formed calculus, as well as to clear the lumen of the ureter from the “stone path” that shock wave lithotripsy leaves behind.

This technique is not inferior in its effectiveness to DLT, however, due to the risk of complications, its use is largely limited, especially when it comes to the treatment of urolithiasis in children (since the lumen of the urethra is quite narrow, which makes it difficult to insert an endoscope).

The main complications after the procedure are as follows:

advancement of the stone into the pyelocaliceal apparatus of the kidney;
traumatic impact on the walls of the ureter or its perforation, which causes bleeding;
inflammation of the kidneys (acute pyelonephritis) or prostate gland (acute prostatitis), as a result of an unrecognized infection of these structures or a violation of asepsis during the procedure;
complete rupture of the ureter (this happens extremely rarely).

Percutaneous nephrolithotripsy

Treatment of urolithiasis with this method is indispensable for large stones or when the disease is complicated.

Drainage is performed through the nephrotomy tract under mandatory ultrasound control. The stone is destroyed using different lithotripters (electric pulse, ultrasonic, pneumatic and others).

Despite the high efficiency of the procedure, it has disadvantages, the first of which is invasiveness and trauma. Possible complications include:

puncture of large vessels due to incorrect puncture;
injury to organs located in the abdominal or pleural cavity;
the formation of a large hematoma under or around the kidney capsule;
a blood clot enters the pelvis, which threatens it with complete tamponade.

Operation open

When the above methods of surgical treatment are ineffective or their use is limited, open surgery is used.

To remove the stone, one of the following operations is used:

ureterolithotomy;
pyelolithotomy;
pyelonephrolithotomy;
nephrectomy (complete removal of an organ is resorted to in emergency situations, for example, in case of widespread kidney abscess or when it shrinks).

Spa treatment

Treatment in sanatoriums for patients suffering from one or another form of urolithiasis is balneological (therapy with mineral waters).

Each water has its own gas and mineral composition. When used correctly, it is possible to influence the process of breaking down stones and their natural elimination from the body.

The main effects of balneological treatment are as follows:

gently accelerate the process of diuresis;
anti-inflammatory effect;
eliminate the spastic component from the smooth muscles of the ureters;
adjust urine pH in the required direction.

In each specific case, only the doctor determines the need for sanatorium treatment, because there are certain contraindications for it (for example, the presence of large stones or severe concomitant diseases).

Conclusion

Unfortunately, it is impossible to completely cure urolithiasis and rid the patient of this condition. However, if you follow all medical recommendations regarding nutritional correction and lifestyle changes, you can stop the pathological process for a long time.

Drugs for the treatment of urolithiasis 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 benzoic 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 that relieve pain and reduce 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 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 effective means 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 nonsteroidal anti-inflammatory drugs for urolithiasis is the presence of an inflammatory process in the kidney tissues 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:

relief of pain syndrome;
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 that complicates 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 able to create a situation with blockage of the urinary tract. Also, for such therapy, the composition of stones and their ability to dissolve are of great importance. Potassium-sparing diuretics are prescribed for patients prone to the formation of phosphate or calcium stones. Whereas oxalates require the use of diuretics of a thiazide nature.

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 sufficient 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.

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Pathological processes in the kidneys are diagnosed more and more often with age. When the first symptoms of urolithiasis appear, it is very important to contact a urologist who will be able to choose the right drugs for the treatment of urolithiasis. With the help of drug therapy, it is possible to prevent the dangerous consequences and complications of the disease.

Medicines for urolithiasis are selected depending on the source of infection and the type of pathogen, the duration of the pathological process and the severity of symptoms.

The main goals of therapeutic intervention are:

getting rid of the cause of the disease - eliminating the inflammatory process, dissolving and removing sand and stones;
eliminating the severity of clinical manifestations so that the kidney restores its functions;
prevention of the occurrence of diseases in the future (immune-strengthening therapy, vitamin therapy).

Antibiotics

An antibiotic for urolithiasis is necessary in order to achieve maximum effectiveness from the therapeutic effect. Antibiotics used in treatment should have the following properties:

antimicrobial activity against pathogens;
eliminating barriers to microbial resistance;
creation of active components in urine and blood fluid.

Stone-dissolving drugs

Antispasmodics

improve the microcirculation of the blood fluid, as the vessels dilate after the use of drugs;
remove hidden swelling from tissues;
expand the lumen of the urinary tract, so that the stones will be removed quickly and painlessly.

Myotropic agents have a relaxing effect on muscle fibers, due to this, spasm is relieved. The action of such drugs on average lasts no more than three hours, so they are prescribed two or three times a day. The most common medications in this category are: No-shpa, Papaverine, Eufillin, Dibazol. Urolithiasis is often treated with No-shpa; it is a safe medication for the body and works quickly. Urologists prescribe myotropic drugs for acute urolithiasis in the form of intravenous droppers in the morning and evening, so they will quickly relieve pain.
An effective drug is Tamsulosin. It reduces muscle tone and improves detrusor function. It is prescribed once a day. Do not use in case of severe liver diseases or in the presence of hypertension. For renal colic, which is accompanied by urolithiasis, analgesics and antispasmodics are used: Maxigan, Spasmalgon, Trigan. One tablet is prescribed twice a day.

Diuretics

Painkillers

Herbal medicines

When prescribing therapy, doctors additionally recommend the use of herbal medicines. They help cure diseases and prevent their exacerbations in the future. The most popular among this category are: Canephron, Cyston, Urolesan, Gentos, Fitolizin.
Kanefron is an effective anti-inflammatory, diuretic and antispasmodic drug. With its help, stone crushing occurs faster. Only such a therapeutic effect occurs after prolonged use of the product. It also restores kidney function, relieves pain, relieves the inflammatory process. After starting therapy, a person feels relief within a few days. The composition of Kanefron contains such plants: Rosemary, Centaury, Lovage. The anti-inflammatory drug is produced in the form of tablets (for patients over the age of seven), drops (for patients under the age of 7). The duration of treatment is 60 days.
Cyston – the base contains medicinal plants and mumiyo. It has a bactericidal property, increases the body's natural defenses, prevents the formation of stones. Often prescribed during treatment with antibacterial drugs. Can be used as a preventative medicine. Recommended doses are two units in the morning and evening.

Nephroleptin is a modern medicine for urolithiasis. It is based on: Propolis, Licorice root, Bear's Ears, Lingonberry leaves, grass of the bird Highlander. Has the following properties:

diuretic;
anti-inflammatory;
restorative.

Horsetail;
onion peel;
Fenugreek;
Parsley;
Wheatgrass;
avian Highlander;
Lovage.

It is possible to overcome severe kidney diseases!

If the following symptoms are familiar to you firsthand:

constant lower back pain;
difficulty urinating;
blood pressure disorder.

The only way is surgery? Wait, and do not act with radical methods. It is POSSIBLE to cure the disease! Follow the link and find out how the Specialist recommends treatment.

One of the most unpleasant and common diseases is kidney inflammation.

It is accompanied by severe pain and numerous other symptoms. Modern methods diagnostics can reveal both the degree and complexity of the disease in a patient.

It is very important to consult a doctor as early as possible who will prescribe specific therapy. This treatment program does not consist of choosing drugs at random, but of selecting specific drugs based on laboratory results.

In each individual case, the doctor prescribes certain types of antibiotics that will most effectively help each individual patient.

For each case - its own drug

In medical practice there is different variants inflammatory kidney diseases. All of them can be treated quite effectively using a complex of different methods. One of them is the prescription of antibiotics, without which not a single course of treatment for kidney inflammation is complete.

There are several groups of antibiotics that are most often prescribed by doctors:

Aminopenicillion group of drugs. These include drugs such as Penicillin and Amoxicillin. Their main advantage is the effective fight against enterococci and E. coli. This group of antibiotics is prescribed to nursing and pregnant women. However, such drugs are not able to cope with pyelonephritis.
Cephalosporin group. Among these antibiotics, Cephalexin is especially distinguished. Its active ingredient is 7-ACC acid. It quickly prevents the transition of an inflammatory disease from one stage to a more complex and serious one. The medicine is contraindicated for patients who are intolerant to penicillins. This group of antibiotics includes drugs such as Cefalotin, Zinnat, Clarofan. Taking all these medications significantly improves the patient’s condition already on the 3rd day.
Fluoroquinolone group. The doctor prescribes these drugs if there is a risk of death or a serious complication for the patient. These first generation antibiotics include Fleroxacin, Ciprofloxacin, Ofloxacin and many others. In case of chronic kidney inflammation, the doctor prescribes second-generation antibiotics of this group: Sparfloxacin, Levofloxacin. They effectively cope with pneumococci. Contraindications to the use of these drugs are: epilepsy, pregnancy, liver or kidney failure, atherosclerosis, old age.

TOP 5 most popular drugs

The most popular and frequently used antibiotics for kidney inflammation today are:

Levofloxacin. Can be taken either as tablets or as injections. Depending on the disease, the doctor prescribes 200-700 mg of the drug 1-2 times a day. It is not recommended to use the product for pregnant women, as well as people with intolerance to the components of the drug. The medicine has side effects: dizziness, diarrhea, possibility of developing candidiasis.
Ciprofloxacin used in an individual dosage regimen, which is determined by the attending physician. Usually prescribed 250-750 mg 2 times a day or intravenously 200-400 mg. Patients with epilepsy should take the medicine with caution. renal failure and other serious diseases.
Pefloxacin. The dosage of this antibiotic is also selected individually for each patient. It depends on the severity and location of the infection. If an uncomplicated infection is observed, the doctor prescribes 0.4 g of the drug 2 times a day. If the disease is more severe, then you will have to take a dose twice as large. The tablets should be swallowed without chewing them, and then washed down with water. The product should only be taken on an empty stomach.
Ampicillin Used only in cases of moderate infection. In all other cases, the drug will be ineffective. The medicine is administered intramuscularly at 1-2 million units per day. Moreover, this dose should be divided into 4 administrations.
Cephalothin. Effective drug with inflammation of the kidneys. It is administered either intravenously or deep intramuscularly. The product is also available in tablet form. Usually a dose of 0.5-2 g is prescribed every 6 hours. The drug should be used with caution during pregnancy and in case of renal failure.

Kidneys hurt after taking antibiotics - is it time to see a doctor?

Some patients have a problem after being prescribed antibiotics - their kidneys begin to bother and hurt.

In this case, you should immediately consult a doctor:

another medicine will be prescribed or the dosage of one already prescribed will be reduced;
he will prescribe probiotics that will restore the body’s microflora;
will advise you to drink a lot of water to remove unnecessary harmful substances.

Treatment of cystitis

For cystitis, the doctor prescribes antibiotics only when the cause of the disease is bacteria and microbes.

List of antibiotics that are most often used for cystitis:

Furagin;
Monural;
Nocilin;
Palin;
Furadonin;
Levomycetin.

These antibiotics have been used for cystitis for several decades. These drugs have an antimicrobial effect and are resistant to many other medications.

Palin tablets are modern new generation antibiotics. Their main advantage is a minimum of contraindications.

It is also possible to overcome pyelonephritis

Before determining the most effective antibiotic, which will help in the treatment of pyelonephritis, you need to undergo examination.

It will help identify the causative agent of the disease, understand the condition of the kidneys and urine outflow.

Because Since the main role in the development of pyelonephritis is played by bacteria, its treatment cannot be done without the following antibiotics:

for mild forms - Cefaclor, Ampicillin, Gentamicin;
in case of poor urine outflow or the presence of renal failure, Furazolin, Furadonin, Furagin are prescribed.

Application features

During pregnancy, numerous physiological changes occur in the female body. Because of this, expectant mothers often experience kidney pain. This sign indicates that inflammation has occurred.

Doctors try to treat pregnant women without using antibiotics. However, this is often impossible, especially as the problem progresses. In this case, Ceftriaxone or Cefazolin is prescribed.

Penicillin will help cure cystitis during pregnancy or during breastfeeding. This drug practically does not penetrate into milk, so it cannot harm the baby.

However, breastfeeding women may develop diarrhea, thrush or a rash after a course of treatment with Penicillin. During pregnancy or lactation, it is better not to take antibiotics at all.

Mild antibiotics are also often prescribed to treat kidney inflammation in children. Along with them, probiotics are also prescribed, which will help preserve the baby’s intestinal microflora.

Treatment is prescribed only by a doctor!

Kidney inflammation is a disease that requires close attention. If treated incorrectly, this process can drag on for many years.

Without an examination by a specialist, it is impossible to find out why the kidney inflammation occurred. And after the examination, the doctor will immediately prescribe a course of treatment. And if you stick to it, recovery comes quite quickly.

Only a doctor can help you choose one or another antibiotic for kidney inflammation.

This depends on many parameters:

the type of microorganisms that caused the problems;
the sensitivity of these microorganisms to certain drugs.

The dosage of the medicine is also selected individually, based on research results:

laboratory tests;
computed tomography;

The key to a quick and successful recovery is proper treatment of kidney inflammation. Therefore, it is simply impossible to do without a doctor in this matter.

At the first symptoms of this problem, you need to go to a specialist. No need to tighten!

Symptoms of urolithiasis

Pain syndrome - severe pain in the lumbar region, radiating along the ureter to the groin, can be dull and constant. The attack is called “renal colic”, its nature largely depends on the size and location of the stone. Pain with urolithiasis is often associated with shaking, severe physical activity and driving.

In this case, the pain may vary depending on the migration of stones or their standing still. When stones move, a disturbance in the outflow of urine may occur. Pain when a stone passes the lower third of the ureter spreads in men to the testicle and head of the penis, in women - to the labia. Increased urination and other dysuric phenomena may occur.

An attack of urolithiasis is usually accompanied by chills, fever, leukocytosis, nausea, vomiting, and hematuria (blood in the urine). Sometimes spontaneous stone passage is observed and obstructive anuria is extremely rare.

Classification of stones

Urinary stones are formed as a result of the following metabolic disorders:

with hyperuricemia (increased levels of uric acid in the blood);
with hyperuricuria (increased levels of uric acid in the urine);
with hyperoxaluria (increased levels of oxalate salts in the urine);
with hypercalciuria (increased levels of calcium salts in the urine);
with hyperphosphaturia (increased levels of phosphate salts in the urine);
when the acidity of urine changes.

Stones in urolithiasis can be urate, calcium, phosphate, cystine or mixed.

Complications of urolithiasis

The most common complications of urolithiasis:

Chronic inflammatory diseases of the urinary system (cystitis, pyelonephritis, urethritis).
Paranephritis is the formation of pustules in the renal parenchyma or kidney carbuncle, as well as necrosis of the renal papillae, leading to the development of a septic process.
Pyonephrosis is purulent melting of the kidney.
Rapidly progressing chronic renal failure, nephrosclerosis.
Acute renal failure is rare with obstruction of the urinary tract of a single kidney or with a bilateral process.
Anemia.

Urolithiasis: treatment

In the treatment of urolithiasis, both conservative and surgical methods. Traditional methods of therapy are sometimes very effective for this pathology.

The main points in the treatment of urolithiasis are the removal of kidney stones and the correction of metabolic disorders. For stone sizes up to 0.5 cm, special medications having lithotropic properties, if the stone is larger, they resort to ultrasound lithotripsy or surgery.

Diet for urolithiasis of the kidneys

The diet for urolithiasis depends on the chemical composition of the stone, but also has a number of general recommendations, such as:

Drinking regimen - you should drink at least 2 liters of liquid per day;
Consuming foods rich in fiber.

If you have urate stones in your diet, you should limit your consumption of smoked and fried meat, as well as in the form of meat broth, chocolate, legumes (beans and peas), cocoa and coffee. You should completely avoid spicy foods and alcohol.

If you have calcium stones, you should limit your intake of lactic acid products, cottage cheese, cheese, strawberries, carrots, lettuce, sorrel, black currants, coffee, cocoa. You should definitely take vitamin B6 three times a day, 0.02 g with meals for a month.

If you have phosphate stones, limit your consumption of all dairy products, as well as eggs, fruits and vegetables. It is recommended to eat more fish, meat and flour dishes.

If you have cystine stones, you should consume 3 liters of fluid per day, while limiting your salt intake.

Treatment of urolithiasis: drugs

To relieve a painful attack, analgesics and antispasmodics (analgin, no-spa, baralgin, ketarol) are prescribed. Sometimes the pain attack is so severe that it can only be relieved by the administration of narcotic analgesics.

Medicines for urolithiasis are also prescribed taking into account the chemical composition of the stone.

When treating uric acid stones, the course of treatment is usually a month. Drugs such as allopurinol and blemarene are prescribed.
When treating calcium oxalate stones, hypothiazide, magnesium oxide or asparginate, vitamin B6 and blemarene are prescribed.
When treating calcium phosphate stones, antibacterial therapy, hypothiazide, magnesium ascorbate, boric acid, methionine and herbal remedies.
In the treatment of cystine stones, ascorbic acid, penicillamine and blemarene are used.

Antibiotics for urolithiasis are prescribed in the presence of an inflammatory process, depending on the results of urine culture.

How to treat urolithiasis without surgery

Methods for removing calculus (stone):

medicinal litholysis with special preparations;
instrumental removal of stones descended into the ureter;
percutaneous stone removal by extraction (litholapoxia) or contact lithotripsy;
contact ureterolithotripsy, ureterolitholapoxia;
extracorporeal lithotripsy (ESLT);

All these methods are minimally invasive and minimally traumatic and are successfully used to destroy and remove stones from the urinary tract.

Surgical methods for treating urolithiasis

Indications for surgical removal of a stone are stone sizes greater than 5 cm or stone wedging into the ureter. Open operations are rarely performed today. The operation consists of two stages: crushing the stone and removing it, and is very traumatic.

Treatment of urolithiasis with folk remedies

Many patients use herbs for urolithiasis with good results.

The use of the Jordanov collection helps well: mix equal parts of nettle and mint leaves, calamus rhizomes, horsetail grass, black elderberry flowers and juniper and rose hips, brew two tablespoons of the collection with 1 liter of boiling water, take 50 ml with meals 2-3 once a day.

To remove small stones from the kidneys, diuretic herbs are used for urolithiasis:

For phosphate and calcium stones, a herbal mixture is prescribed: madder, parsley, lingonberry, rue, St. John's wort, bearberry, burdock, calamus.
For uric acid stones, birch, strawberry and lingonberry leaves, dill seeds, parsley fruits, and horsetail are recommended.
For oxalate stones, take dill seeds, knotweed, strawberries, horsetail, peppermint and corn silk.

An infusion is prepared from 2 - 3 herbs: 2 tablespoons of herbal collection are steamed with one liter of boiling water and infused for 2-3 hours. The product is taken three times a day, 20 ml for 2-3 weeks.

Interesting video on the topic of urolithiasis, symptoms and treatment of urolithiasis

In pharmacies you can purchase combined herbal preparations: cystone, cystenal, phytolysin and prolit.

Sanatorium-resort treatment for urolithiasis

Mineral water for urolithiasis is recommended depending on the chemical composition of the stone. Patients suffering from uric acid or calcium oxalate urolithiasis are advised to undergo treatment in sanatoriums with low-mineralized alkaline waters: Zheleznovodsk (“Slavyanovskaya”), Pyatigorsk, Kislovodsk (Narzan), Essentuki (Essentuki No. 4, 17).

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. In the early stages of the disease, they are irreplaceable due to their ability to penetrate directly into the source of infection and accumulate there in a 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.

Urolithiasis (UCD) is still one of the most common urological diseases. The incidence of urolithiasis by region ranges from 25.5% to 41.5%, and patients with various forms of this pathology occupy 35–50% of the bed capacity of urological hospitals. According to many authors, this disease, as a manifestation of metabolic disorders, will tend to increase due to the deterioration of the environmental situation.

Why and why?

There is currently no unified concept of the etiopathogenesis of ICD, since its development is influenced by the state of many organs and systems of the body - both congenital and acquired pathology, as well as poor socio-economic conditions, environmental pollution, etc., and therefore A number of authors classify this disease as a so-called disease of civilization. Modern ideas about the etiopathogenetic process of stone formation are presented in the diagram.

Climatic and biogeochemical factors (the latter include chlorides, sulfates, pesticides in water and food) have a direct toxic or indirect effect on the human body, causing metabolic disorders in biological environments, and ultimately lead to the occurrence of tubulopathies, manifested by a violation of purine, oxalate, acid and phosphorus-calcium metabolism. An increase in the concentrations of stone-forming factors in the blood serum and urine leads to crystalluria, which, with a lack of substances that maintain the colloidal stability of urine and contribute to the maintenance of salts in dissolved form, as well as with changes in urine pH, leads to the clumping of crystals and thereby to the formation of microliths, which is trigger for stone formation. These substances include solubilizers (hippuric acid, xanthine, sodium chloride, citrates, magnesium), as well as crystallization inhibitors (inorganic pyrophosphate, zinc, manganese, cobalt ions), the concentration of which in the urine of patients with urolithiasis is usually reduced. In chronic pyelonephritis, the main role in stone formation is played by metabolic products of a number of microbes (phenols, cresols and volatile fatty acids), which also disrupt the metastable state of salts in a supersaturated solution. Various kidney anomalies, disturbances in the urodynamics of the upper urinary tract, microcirculation and other pathologies also play a huge role in stone formation.

Depending on the type of metabolic disorder or the presence of infection, urinary stones can have a different chemical composition: some of them have a monostructural structure, but polymineral, or mixed structure, stones are more common. Knowledge of the structure of the stone plays an important role when choosing methods of treatment and prevention. Currently, urologists around the world recognize the mineralogical classification of urinary stones.

Features of the diagnosis of ICD

Diagnosis of ICD is based primarily on the patient’s complaints, of which highest value have attacks of renal colic, especially repeated ones. In the period between attacks, dull pain in the lumbar region, passage of stones, and hematuria are observed, which usually occurs after physical activity.

General clinical research methods can identify signs of damage to the kidney and urinary tract (positive Pasternatsky's sign, pain on palpation in the kidney area or along the ureter, palpable kidney).

A blood test done during renal colic or an attack of pyelonephritis complicating ICD reveals leukocytosis, a shift in the leukocyte formula to the left, toxic granularity of neutrophils, and an increase in ESR.

A small amount of protein, single cylinders, fresh red blood cells and salt crystals are found in the urine; with pyelonephritis - leukocyturia.

X-ray examination plays a leading role in identifying stones in the kidney or ureter. The most common method is survey urography. With its help, you can determine the size, shape of the stone, as well as its location. If necessary, in the case of a coral stone or doubts regarding the involvement of the shadow in the urinary tract, pictures are taken in two projections. A survey urogram should cover the entire area of the kidneys and urinary tract on both sides.

But not all stones give a shadow on a survey image, and in some cases a shadow suspicious for a stone may belong to a gallbladder stone, a foreign body, a calcified lymph node, etc. In the projection of the small pelvis, rounded shadows are often visible - phleboliths, similar to stone. After survey urography, excretory urography should be performed, which makes it possible to clarify whether the shadow relates to the urinary tract, as well as to determine the anatomical and functional state of the kidneys and the localization of the stone (in the pelvis, ureter). With an X-ray negative stone, a filling defect corresponding to the calculus is visible against the background of a radiopaque substance. As a rule, an excretory urogram gives a complete picture of the excretory function of the kidney, however, after an attack of renal colic, the kidney is in a state of blockade and the release of a radiopaque substance on the affected side may be absent. When studying kidney function, isotope methods are of great help.

Ultrasound examination of the kidneys and bladder occupies a certain place in the diagnosis of urolithiasis. An indirect symptom in favor of the presence of an upper urinary tract stone can be the expansion of the collecting system.

Retrograde pyelography with liquid X-ray contrast agent or oxygen (pneumopyelography) is done only in cases where there are doubts about the diagnosis or the shadow of the stone is not visible, which usually happens with an X-ray negative stone.

When making a differential diagnosis, it is very important not to miss acute appendicitis, acute cholecystitis, perforated gastric ulcer, acute intestinal obstruction, acute pancreatitis, ectopic pregnancy and a number of other diseases.

All means are good...

Over the past 10 years, due to widespread implementation in urological practice Modern technologies for removing stones from the kidneys and urinary tract have significantly changed the tactics and strategy for treating this disease. It should be emphasized that KSD is a surgical pathology, and only in 5% of patients (their stones consist of uric acid salts) conservative methods, in particular litholysis, are effective. The most widespread (in almost 85% of cases) is the use of external shock wave lithotripsy (ESWL), which is less traumatic.

As already mentioned, DLT has rightfully taken a leading place in the treatment of kidney and ureteral stones. This simple, low-traumatic and cost-effective method of treating stones is the method of choice along with endoscopic and open surgical interventions. The use of DLT is especially effective for relatively small stone sizes (up to 2 cm) and preserved functions of the affected kidney. Well-established medical examination of the population and the use of this method of treatment allow us to count on a significant reduction in severe forms of urolithiasis, complicated by urosepsis and renal failure, which are the main cause of death in patients with this disease.

Today we can say with confidence that DLT is widely introduced into clinical urological practice.

At the same time, new ones have been mastered and continue to be developed operational methods, allowing in most cases to avoid open surgery and achieve the desired result with less risk to the patient. These include various endourological operations. The main criterion for choosing a method for endoscopic stone destruction is the size, shape, position and duration of the stone's presence in the ureter. Currently, indications for treating urolithiasis with laser are expanding.

Possibilities of pharmacotherapy for ICD

Considering that any operation to remove a stone is essentially a symptomatic treatment, it should be noted that the role of various conservative methods of treating urolithiasis (medicines, physiotherapy, balneotherapy and herbal medicine) is increasing, aimed at correcting metabolic disorders and preventing relapses of stone formation.

In our practice, we widely use herbal medicine, which helps improve urodynamics in the upper urinary tract and more rapid passage of stones or fragments and sand after their destruction using DLT. In this case, preference is given to official drugs that are easy to use (Avisan, olimetin, marelin, phytolit, cystone, phytolysin, nieron, uroflux, uralit, cystenal, rovatinex, kedzhibelling, etc.), some of which increase the concentration of protective colloids in the urine.

For renal colic caused by ureteral stones, analgesics and antispasmodics (baralgin, maxigan, trigan, etc.) or intramuscular administration of diclofenac (voltaren, dicloran, etc.) are indicated. It is often necessary to prescribe so-called lytic mixtures containing promedol or non-narcotic analgesics pentazocine (fortral), butorphanol (moradol), tramadol (tramal), etc.

Research in recent years has shown that in such cases, especially with renal colic that occurs in the first days after DLT, it is advisable to prescribe nonspecific anti-inflammatory drugs (indomethacin, diclofenac, piroxicam, etc.) and antioxidant therapy with drugs such as Essentiale, phospholip, lipostabil, vitamins E and A.

In the presence of pyelonephritis, drugs that improve microcirculation (pentoxifylline and its analogues trental, agapurin, pentilin, relofect, etc.), antiplatelet agents (chimes, persantine), calcium antagonists (verapamil, etc.) in combination with antibacterial agents (antibiotics, sulfonamides) are also used and so-called uroseptics).

Antibacterial therapy is prescribed after urine culture for microflora, determination of the degree of bacteriuria and sensitivity to antibacterial drugs. For mild bacteriuria, it is sufficient to carry out courses of antibacterial therapy taking into account the sensitivity of the microflora, followed by control urine culture. Most often, in such cases, drugs of the nitrofuran series (furagin, furadonin, furazolidone), nalidixic acid (nevigramon, negram), oxolinic acid (gramurin, dioxacin), pipemidic acid (palin, pimidel), nitrocosolin, norfloxacin (nolitsin, norflox and etc.). It is also possible to prescribe sulfonamides, which are sufficiently concentrated in the urine: etazol, urosulfan, cotrimoxazole (Biseptol, Bactrim, Septrin, etc.).

With more pronounced inflammatory process in the kidneys requires the use of antibiotics. In these cases, the causative agents, as a rule, are gram-negative microorganisms from the group of enterobacteria or staphylococci and enterococci. Therefore, it is advisable to prescribe broad-spectrum antibiotics from the group of amino- and carboxypenicillins (ampicillin, oxacillin, ampiox, carbenicillin, ticarcillin), combination drugs (ampicillin in combination with sulbactam sodium, amoxicillin or ticarcillin in combination with clavulanic acid or its salts).

An alternative to semisynthetic penicillins in such cases are first and second generation cephalosporins, which also have a wide spectrum of action: cephalexin, cefadroxil, cefradine, cefaclor, used orally; cephalothin, cephaloridine, cefazolin, cefuroxime, cefamandole, cefotaxime, cefotetan, cefmetazole for parenteral administration. Due to the fact that many drugs are administered orally, treatment can be carried out on an outpatient basis.

However, in severe pyelonephritis caused by multiresistant strains of microorganisms (so-called nosocomial strains), antibacterial (preoperative) therapy should be carried out in a hospital setting, often against the background of drainage of the affected kidney with an internal stent. In such cases, antibiotics from the aminoglycoside group are used (sisomycin, gentamicin, tobramycin, netilmicin, amikacin); third and fourth generation cephalosporins (ceftriaxone, ceftizoxime, ceftazidime, cefpirome); beta-lactam antibiotics (aztreonam, imipenem in combination with cilastatin, meropenem); fluoroquinolones (ofloxacin, ciprofloxacin, enoxacin, pefloxacin, fleroxacin, lomefloxacin, etc.). Of course, the above antibiotics are second-line drugs and are prescribed in severe cases of infection or when first-line drugs have not given the desired result.

It should be noted that complete elimination of infection in urolithiasis, especially if the stone disrupts urodynamics, is practically impossible, and therefore antibacterial therapy is prescribed before and after surgery, especially after radiotherapy.

Prevention and medical examination

After stone removal, patients require constant monitoring and treatment by a clinic urologist for 5 years, which has a positive effect on the outcome of the disease (see diagram). Conservative therapy is carried out aimed at eliminating the infection and correcting metabolic disorders. All drugs are prescribed against the background of an appropriate drinking regime, diet, physical activity and physiotherapeutic procedures.

After eliminating a urinary tract infection, treatment should be aimed at preventing recurrent stone formation. For this purpose, allopurinol, benzbromarone (when the level of uric acid in the blood increases), as well as citrate mixtures (uralit-U, blemarene, etc.) are used. Citrate mixtures have worked well in the presence of urates - treatment with them for 2-3 months often leads to complete dissolution of the stones.

In the preventive treatment of oxalate lithiasis, the drug oxalite C has proven itself well, as well as vitamins B1, B6 and magnesium oxide, which is an inhibitor of calcium oxalate crystallization. For renal hypercalciuria, hypothiazide in combination with potassium-containing drugs (panangin, potassium orotate) is effective. To regulate phosphorus-calcium metabolism, Xidifon is prescribed - the first domestic drug from the group of diphosphonates.

The complex of measures aimed at preventing relapse of the disease also includes sanatorium-resort treatment (Truskavets, Svalyava, etc.).

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, an excess of D, C. A sedentary lifestyle and the 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 according to the results of the following examinations: general urinalysis, ultrasound, radiography of the pelvic organs, intravenous urography, cystoscopy.

To choose correct treatment, it is necessary to determine what components the stones consist of.

There are several types based on their chemical composition. Approximately 60-80% of all stones are inorganic calcium compounds: weddellite, wevellite (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 calculi and often accompany infection. Cystine stones are quite rare (1-3%). Calculi that completely occupy the renal pelvis are called staghorn.

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

Medicines used for nephrolithiasis and urolithiasis

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

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

The method of litholysis, as a rule, affects urates. Considering that such calculi are formed at a reduced pH of urine, it is necessary to maintain the pH balance at the level of elevated values (6.2-6.8) - alkalization of urine should be carried out. This effect is achieved by preparations blemaren, uralit U, soluran, margulit and others.

Blemarin is available in the form of effervescent tablets or granular powder, complete with a control calendar and indicator paper. It contains salts of citric acid - potassium or sodium citrate, which together create an increased concentration of potassium and sodium ions in the urine. However, we must not forget that against the background of the use of 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, the synthesis of peptidoglycan is inhibited, and bacterial lysis occurs. 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 focus of inflammation. Such drugs include ketoprofen, ketorolac, diclofenac and others. However, these drugs are ulcerogenic, so they should be taken with great care.

If the inflammation process is insignificant, nitrofuran drugs (furadonin, furangin, furazolidone), pipemidic acid (pimidel, palin), oxolinic acid (dioxacin, gramurin), norfloxacin (norflox, nolicin), 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 in both the excretion products and in the blood serum, thereby preventing its accumulation in the tissues and kidneys. Allopurinol is prescribed for patients with recurrent urolithiasis with calcium oxolate stones. This drug is prescribed immediately when biochemical changes are detected.

Means 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, pentylin, pentoxifylline, pentylin, 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 infection in urolithiasis does not occur. As a rule, antibiotic therapy is prescribed before and after surgery.