Is it possible to dissolve kidney stones? The urologist tells. Can silicone sealant be dissolved? Dreams of balance

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Instructions

If you have oxalate kidney stones, it is important to follow a special diet. Eliminate from your diet foods containing large amounts of oxalic acid and vitamin C: spinach, sorrel, peppers, lettuce, plums, gooseberries, red currants, cranberries, etc. Do not eat fatty foods, smoked meats, meat and fish broths, canned food, strong tea, coffee, cocoa, kvass. Include milk, cottage cheese, bread, pasta, cereals, low-fat fish and meat in your daily diet. White cabbage, cauliflower, potatoes, apples, watermelons are recommended. Drink plenty of fluid, at least 2 liters per day. Water promotes the movement of sand and fine oxalates and their removal naturally. An active lifestyle helps remove sand and small stones.

For urolithiasis with oxalate stones in the kidneys, medications are prescribed that help crush the stones and remove them from the body, as well as dissolve oxalates at the initial stage of formation. These drugs include Allopurinol and Blemaren. Additionally, preparations based on plant raw materials are used: “Cyston”, “Prolit”, “Fitolysin”, “Urolesan”. In the presence of an inflammatory process, antimicrobial and anti-inflammatory drugs are prescribed. In case of infection, antibiotics and sulfonamides are used (Biseptol, Ceftriaxone, Sulfadimethoxine).

Antispasmodics are prescribed to help relieve spasms and facilitate the passage of stones through the urinary tract (Baralgin, Platifillin, No-shpa, Papaverine). Diuretics are also prescribed: herbal decoctions (bearberry, knotweed, corn silk, bear's ears, etc.). Medicines should not be used independently without first consulting a doctor. The likelihood of spontaneous passage of a stone will depend on its size and the structural features of the urinary system. Stones up to 5 mm in size can pass spontaneously in 67-80% of cases; stones larger than 10 mm in diameter require medical intervention.

External shock wave lithotripsy (a method of crushing stones) can be used in treatment. The therapy uses high-energy shock waves that are directed at the stone and cause it to break into smaller fragments. The source of the waves is located outside the human body, i.e. integrity during treatment skin is not violated. Surgical intervention for urolithiasis with the formation of oxalate stones, it is used in the following cases: when too large sizes stone, if the stone gradually increases in size, if the stone interferes with the outflow of urine.

The Internet is replete with a huge variety of recipes: they say you can dissolve the stone with fir oil, mineral water, sour juices, and even just plain water. Which of this is true and which is not, says Evgeny Shpot, urologist, candidate of medical sciences, associate professor of the department of urology of the medical faculty of the First Moscow State Medical University. I. M. Sechenova

Litholytic therapy - that is, the ureter with the help of medications - is most effective in patients with urate stones. The basis of such stones is uric acid salts.

How to tell the difference?

When diagnosing, urate stones are clearly visible on ultrasound, but, unlike other types of stones, they are not visible on X-ray, which is due to their low density. You can accurately determine the composition of the stone by examining a stone that has previously passed or was removed during surgery. An analysis that confirms the presence of urate stones is pH testing, in which the acidity of the urine is below normal. Sometimes, to clarify the diagnosis, the patient is prescribed a computed tomogram - with the help of this study, you can find out the exact density of the stone. But this study is not necessary: ​​if there is a stone on an ultrasound, but not on an x-ray, and a shift in urine pH toward acidic is repeatedly detected, then you can try to dissolve it.

Often, urate stones occur in patients with impaired purine metabolism, for example, with gout, so all patients with suspected urate nephrolithiasis must determine the level of uric acid in the blood.

Dreams of balance

To dissolve urate stone, you need to lower the level of uric acid - that is, you need to increase the acid-base balance (pH): so that the urine changes from acidic to slightly acidic or alkaline. For this purpose, citrate preparations are prescribed - alkaline drinking. It takes at least 2 months to dissolve urate stones, and depending on the size of the stone, treatment can take up to six months. Therefore, for large urate stones (2 cm or more), it is preferable to first perform a session of remote or contact endoscopic crushing, followed by dissolution of the remaining small fragments. It is important to combine such treatment with a properly selected diet and plenty of fluids.

Unfortunately, we most often come to people whose stone has “gone”, that is, it has traveled from the kidney through the ureter. In this case, there is no longer time for dissolution. After all, the movement of a stone can be accompanied by renal colic and complicated by obstructive pyelonephritis. We have to take emergency measures - remove the stone in one way or another, and dissolve, if possible, the remaining ones.

Myths and facts about dissolving stones

Urate stones can be dissolved with plain water.

This is partly true. With an increase in the volume of fluid consumed, the acidity of the urine decreases and the concentration of salts and small amounts decreases. However, not all urate stones dissolve even with the help of drugs. The stone may be mixed in composition, or medications may not be able to ensure a constant healing pH level in the urine. Therefore, it is recommended to continue treatment with citrate drugs only if there is significant progress. The citrate mixture has a number of side effects, therefore, the prescription of such drugs and evaluation of effectiveness should occur under the supervision of a physician.

Oxalate stones, like urate stones, can be dissolved by drinking alkaline water.

It is important to note that only uric acid stones are reliably soluble during litholytic therapy. The use of citrate preparations for calcium oxalate stones reduces the risk of stone formation after crushing.

To dissolve stones, you need to drink an acidic drink - lemon or cranberry juice.

I had a patient who followed this recommendation. I drank every day for a month lemon juice- and ended up in the hospital with a perforated stomach ulcer and bleeding. Lemon acid- one of several components of citrate preparations, which reduces the absorption of calcium in the gastrointestinal tract, but does not lead to the dissolution of stones.

Fir oil in combination with diuretic herbs allows you to dissolve stones.

Diuretic herbs. While the stone is in the kidney, no treatment is required, only regular observation and a certain diet are required. If you regularly drink diuretic herbs, the stone may move - and this can lead to renal colic and acute inflammation.