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The presence of stone deposits in the bladder, or cystolithiasis, is a disease that is one of the varieties of urolithiasis. This disease is most susceptible to males over fifty years of age, as well as small patients under the age of six. But such a disease also occurs in young women and men.
Causes and symptoms of this disease
Urolithiasis is divided into several varieties, depending on a number of different factors: the location of the disease, the origin of the stones and the severity of the course of the disease.
The place of formation of calculi can serve as the bladder, ureters or kidneys. According to their origin, they are divided into cystine stones, oxalates, phosphate stones, urate and others. The severity of the disease is affected by the primary manifestation of the disease, the formation of calculi, as well as a possible relapse.
There are many reasons that influence the occurrence and development of this disease. But some of them can be identified as the main factors in the formation of deposits in the bladder.
The most common underlying cause of cystolithiasis is impaired urine flow. Often this is due to the presence of prostatic hyperplasia, or simply prostate adenoma. With this disease, an enlarged gland puts pressure on the urethra, and stagnant urine in the bladder leads to salt deposits, from which calculi subsequently arise.
Other most common causes that cause the formation of stones are various infectious and inflammatory processes in the genitourinary system, metabolic disorders in the body, the presence of foreign bodies in the bladder, prostate cancer or adenoma, infravesical obstruction, and others.
Also, to a large extent, the occurrence of calculi is affected by the presence of nephrolithiasis in a patient, since fine-grained stones have the ability to pass from the kidneys to the bladder area and finally develop there.
It often happens that stones in the bladder practically do not make themselves felt, in particular this applies to large calculi. Smaller formations bring more discomfort to the patient. Therefore, it is very important to periodically undergo preventive medical examinations, which can detect the disease at an early stage, which will greatly facilitate subsequent therapy.
Symptoms that may indicate the presence of cystolithiasis are usually expressed as follows:
- pain and pain when urinating;
- pulling pains in the lower abdomen;
- the presence of blood in the urine;
- frequent urge to urinate, especially annoying at night;
- abrupt cessation of urinary processes, accompanied by increasing pain in the lower abdomen and lower back.
The presence of at least one of these symptoms indicates that it is necessary to contact a specialist urologist as soon as possible to determine the cause of such a disorder and make a correct diagnosis.
Diagnosis and treatment of cystolithiasis
Diagnosis of this disease is carried out based on the patient’s symptoms and complaints, as well as on the results of clinical studies that are necessary for making a correct diagnosis, as well as prescribing appropriate therapy. If you suspect the formation of stones in the urinary system, the urologist usually prescribes the following types of examination:
- ultrasonography;
- X-ray examination;
- cystoscopy – a visual examination of the bladder cavity;
- general urine analysis;
- clinical blood test;
- computed tomography of the kidneys and urinary tract;
- magnetic resonance imaging;
- bladder puncture.
You should be aware that there is no conservative treatment for this problem. And in the presence of cystolithiasis, only the surgical removal of stones and various deposits from the bladder is used. And only after that, therapy is applied aimed at treating the root cause of this disease: urinary tract infections, impaired water-salt balance, prostate adenoma.
Methods for removing stones from the bladder
At the moment, getting rid of stones in the urinary system is carried out using various methods: through surgery, with the help of laparoscopy, as well as with the use of cystolithotripsy – crushing stones.
The most aggressive and least frequently used is the surgical removal of stones, which is performed under general anesthesia.
During this operation, with the help of surgical instruments, the anterior wall of the patient’s abdominal cavity is cut, and then an incision is made on the bladder itself, from where all the stones are subsequently removed.
Another method of removing stones and deposits from the bladder is laparoscopic surgery. It is less harmful than conventional surgery, but is also used only in exceptional cases. Such an operation is characterized by the presence of small punctures in the abdominal wall, through which instruments are inserted to remove stones, as well as a miniature video camera.
After the exact location of the stone is found, an incision is made in the internal organ with the help of instruments and the stone is removed. After that, special sutures from absorbable threads that can dissolve are applied to the incision. A contraindication to such an operation is the presence of infectious and inflammatory processes in the body, and in this case, a conventional abdominal operation is used. After laparoscopy, the patient must stay in the hospital for at least four days, and if postoperative complications are not diagnosed at the end of this period, he is discharged and sent home.
Contact and remote lithotripsy
One of the most common methods for removing deposits in the bladder is lithotripsy, in a simple way – crushing stones. Lithotripsy can be contact and remote, each of which has its own advantages and disadvantages, which must be considered before the procedure.
Remote lithotripsy is considered the most painless method for removing stones from the bladder. And this is due to the fact that at the time of this procedure there is no direct contact of the apparatus with the calculus. This technique involves the crushing of stones using a shock wave of directional action. Before carrying out such a procedure, the patient needs to cleanse the intestines with cleansing enemas or medications.
The device that emits such waves is called a lithotripter. The procedure is performed either under local or general anesthesia.
This procedure takes approximately forty to sixty minutes, depending on the amount of deposits. The device is applied to that part of the body – the back or stomach, where the stones are directly located. Under the influence of the shock wave, the stone is crushed into small fragments and is excreted in the urine through the urinary canals over the next few days.
After such an operation, slight pains in the lumbar region or lower abdomen are possible, in some cases renal colic appears. The consequences of such an intervention are often nausea and vomiting, spotting in the urine. Contraindications to remote lithotripsy are pregnancy, narrowing of the urethra, inflammatory processes in the urinary system, pyelonephritis, urethritis and bleeding.
Contact lithotripsy is an innovative method of getting rid of stones from the bladder area, which is carried out by bringing a special tool directly to the stone and then crushing it.
To do this, you need to insert the endoscope into the bladder. With this procedure, you can get rid of all the stones at once. Despite the fact that the impact of the device during contact lithotripsy occurs directly on the calculus, this procedure is considered non-invasive, since there is no violation of the skin with it.
This technique is divided into several types:
- laser;
- ultrasonic;
- pneumatic.
Ultrasonic stone crushing is performed under general anesthesia. Before the procedure, it is necessary to clean the intestines with an enema. Exposure to stones with ultrasound allows them to be crushed into fragments with a diameter of less than one millimeter, after which they are excreted naturally in the urine. This procedure is excellent for crushing low density stones.
Laser fragmentation is currently considered the most effective and highly productive method of all available. The laser beam acts on the calculus, crushing it into tiny particles to the state of sand or dust, no matter where it is located.
The technique of performing this procedure does not affect nearby healthy tissues, but has only a directed effect. It is because of this that the removal of deposits in the bladder with a laser has more advantages and fewer complications than any of the procedures described.
With pneumatic lithotripsy, the removal of deposits in the bladder is performed using a special metal probe.
Crushing of the calculus occurs due to compressed air directed directly to the stone, after which small fractions are excreted from the body through the urethra. One of the disadvantages of this technique is the high probability of damage to nearby soft tissues, as well as the possibility of stones getting into the kidneys.
Contraindications to any type of lithotripsy are:
- prostatitis;
- exacerbation of chronic diseases of the gastrointestinal tract;
- gestation period.
In conclusion
Removal of stones from the bladder is currently carried out in several ways. The most effective, popular and widespread technique is the crushing of calculi without surgical intervention, by means of a shock wave, laser, pneumatic or ultrasonic lithotripsy.
These methods have the least possible consequences and complications, and also allow you to quickly get rid of all the stones. However, it should be remembered that in order to get rid of the formation of new stones or the recurrence of the disease, it is necessary to treat not only its consequences, but also the root causes.
That is, conservative therapy should be aimed at getting rid of the disease that caused the appearance of deposits in the urinary system.