Increased fluid intake may help pass small bladder stones. However, for larger stones, other methods of treatment may be required.
When treating stones in the bladder, you should remove the symptoms, as well as get rid of the stones.
Note that antibiotics for bladder stones are used for pyuria (the presence of pus in the urine) and the development of urethritis or cystitis. And also in the case of struvite stones, accompanying frequent inflammation of the bladder. In such cases antibacterial preparations of the group of cephalosporins, fluoroquinolones or macrolides are prescribed, read more - Antibiotics for cystitis
Is it necessary to remove stones in the bladder? According to urologists, if you have bladder stones, they should be removed as soon as possible, otherwise they will become larger. Small stones (up to 2 mm) can be eliminated by consuming large amounts of water. However, one should take into account the fact that the male urethra has a curved configuration and a different internal diameter (with three zones of significant narrowing of the internal lumen), so it is unlikely to "wash" a stone with a transverse dimension of more than 4-5 mm. But in women it is possible, because the internal lumen of the urethra is larger, and it is much shorter.
So, if the stones can not be washed out of the bladder naturally, they still need to get rid of: dissolve, take medication, or remove with lithotripsy.
Read also - How urolithiasis is treated
Dissolution of stones in the bladder
Dissolution of stones in the bladder is carried out with drugs that reduce the acidity of urine and make it more alkaline. This can be done with sodium bicarbonate, that is, baking soda.
However, there is a risk of formation of calcification in the kidneys, as well as an increase in the sodium content in the blood (hypernatremia), which is manifested by general dehydration, weakness, increased drowsiness and convulsions. In addition, overly aggressive alkalinization can lead to precipitation of calcium phosphate on the surface of an already existing stone, making further drug therapy ineffective.
So, to reduce the acidity (alkalinization) of urine, drugs such as:
- Potassium citrate (potassium citrate), which can cause nausea, eructation, heartburn, vomiting, diarrhea, as well as hyperkalemia with such consequences as muscle weakness, paresthesia and cardiac arrhythmia right up to the heart block.
- Oxalite C (Blomaren, Soluran, Uralit U) - 3 grams two or three times a day (after meals).
- diuretic diacarb (Acetazolamide, Dehydratin, Diluran, Nephramid, Renamid and other trade names) increases diuresis and quickly makes urine alkaline (pH 6.5-7.). But it is used no longer than five days, taking a tablet (250 mg) twice a day with an interval of 8-10 hours. The drug is contraindicated in patients with acute form of renal insufficiency, diabetes mellitus and a low level of potassium in the blood.
Drugs can help dissolve only urate (uric acid) stones and reduce the calcium in the urine (so that it does not settle with crystals). Cystenal in the form of a solution (contains tincture of the root of the madder dye and magnesium salicylate) - takes three to five drops to three times a day (30 minutes before meals); At the same time, you should drink more liquid (up to two liters per day).
Cystone also refers to herbal remedies. It is used with oxalate stones measuring less than 10 mm - two tablets three times a day (after a meal), the course of treatment lasts three to four months.
The drug Rovatinex, containing terpenic compounds, is used to dissolve calcium salts - three times a day for one or two capsules (within a month). Possible side effects, which are manifested by a feeling of discomfort in the stomach and vomiting.
And the drug Allopurinol, which reduces the synthesis of uric acid, is designed to reduce the recurrence of formation of renal calculous stones in patients with elevated urate content in serum and urine.
With stones in the bladder and kidneys, vitamins B1 and B6, as well as magnesium preparations (magnesium citrate, Solgar, Magne B6, Asparka, etc.) are needed, since this microelement prevents the crystallization of calcium salts contained in the urine.
Removal of stones from the bladder
Used in urology, modern methods of removing stones from the bladder are based on ultrasonic and laser technologies and do not require open surgical intervention.
Contact lithotripsy of stones in the bladder is carried out endoscopically - by direct contact of the lithotripter with calculi. This method involves the use of different techniques provided by different equipment). In particular, lithotripsy or crushing stones in the bladder by ultrasound allows to destroy the concrements into small (up to 1 mm) parts with their subsequent removal from the cavity of the bladder by forced diuresis. The procedure is performed under regional or general anesthesia.
With contact laser cystolitholapaxy, the crushing of the stone in the bladder by the laser is also performed endoscopically, but with transurethral access under general anesthesia. The holmium laser copes with the densest concrements of any composition and size, turning them into dust-like particles, which are then washed out of the bubble.
The contactless method - remote lithotripsy of stones in the bladder (shock wave) - consists in the impact of ultrasonic pulses directed to the stones through the skin on the abdomen or lower back (localization is refined and the entire process is monitored by ultrasound). The stones should be destroyed to the state of fine sand, which then comes out with urination, enhanced by the appointment of diuretics.
Among the contraindications for the fragmentation of stones, urologists call stenosis of the urethra, inflammation of the urinary tract, bleeding and malignant neoplasms in the small pelvis.
Some stones are so large that surgical treatment in the form of open cystotomy may be required. That is, a cut of the abdominal wall is made above the pubis and the bladder is dissected, and the stones are removed manually. Such surgical removal of stones from the bladder is carried out under general anesthesia and requires a catheterization of the bladder through the urethra. Possible side effects of this operation: bleeding, damage to the urethra with scarring, fever, attachment of a secondary infection.
In most cases, alternative treatment of bladder stones includes home remedies to prevent their formation. Recommend:
- drink orange and cranberry juice;
- take after dinner a decoction of leaves of grapes (25 grams per glass of water), with the addition of 20-30 ml of grape juice;
- daily on an empty stomach to drink a tablespoon of fresh onion juice or juice from the root of parsley and black radish (mixed in equal proportions);
- every day to drink a decoction of dried leaves, flowers and fruits of hawthorn prickly with the addition of a teaspoon of lemon juice for 200 ml of broth;
- at phosphate concrements in the morning and in the evening take apple cider vinegar (a tablespoon for half a cup of water).
No studies have confirmed that herbal treatment can destroy bladder stones. However, some medicinal plants are part of the pharmaceuticals.
With phosphate stones, phytotherapists recommend using a madder root dye in the form of 10% alcohol tincture (20 drops twice a day, after meals). And if stones are uro-acid, advise once a day to drink a glass of decoction from the flowers of calendula. Fruits (seeds) of the plant of the umbrella ammoni family (in the form of a decoction prepared from them) relieve spasms of the urinary tract, which facilitates the escape of small stones, but using this plant, one should drink plenty of water (up to two liters a day).
Sporish (mountain bird bird), due to the presence of silicon compounds in it, helps dissolve calcium in the composition of stones. Decoction is prepared from the calculation - a tablespoon of dry herbs for 200 ml of water; Drink three times a day for 30-40 ml (before eating).
Use and diuretic herbs, such as dandelion leaves, horsetail and nettle dioecious.
Diet and nutrition
Since urine is a waste of metabolism in the body, diet and nutrition can be adjusted to restrict its composition, limiting the use of certain foods that increase the level of urate salts (urates), oxalates (oxalic acid salts) or phosphate salts (phosphates).
Read - Diet with urolithiasis
If stones in the bladder consist of oxalates, you should reduce the use of all solanaceous cultures (potatoes, tomatoes, peppers, eggplants) and legumes, nuts. And from sorrel, spinach, rhubarb and celery is better to give up altogether. More information in the material - Diet with oxalate in urine
In nutrition with stones from salts of uric acid, nutritionists recommend focusing on dairy and wholemeal products and refusing to eat red meat, fat, offal and strong meat broths. It is animal proteins that result in nitrogenous bases and uric acid. It is more useful to replace meat with chicken, but it should be consumed a couple of times a week, in small amounts and better in boiled form. For more information, see - Diet with increased uric acid
Dietary recommendations in the case of phosphate calculi concern products that contain a lot of phosphorus and calcium, since it is their compound (with an excess of both nutrients) that leads to the formation of insoluble calcium phosphate. So all milk and sea fish, as well as lentils and soybeans, green peas and broccoli, sunflower seeds and pumpkins, pistachios and almonds - are not for such patients. Although phosphorus is one of the substances used by our body to maintain a normal pH level.
Some vegetables and fruits contribute to diuresis, that is, reduce the concentration of salts in the urine. They include citrus fruits, cucumbers, cabbage, beetroot, pumpkin, watermelons, grapes, cherries, peaches, leafy greens (parsley and coriander), garlic, leek and onions.