Crushing stones in the ureter: how and what they crush (laser, etc.)

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The formation of kidney stones is a fairly common problem. Such structures can have different sizes, shapes and compositions. This pathology is quite dangerous, because neoplasms often block the urinary tract, preventing the removal of fluid from the body. It is in such cases that crushing stones in the ureter is necessary.

Of course, when faced with the need to undergo such a procedure, patients look for any additional information. So how does stones break up in the ureter? What methods does modern medicine offer? Are there any contraindications to such a procedure? How long does the rehabilitation period last? The answers to these questions will be useful to many.

Diet for oscalate, phosphate and urate kidney stones

Diet for urolithiasis #8212;
is not only a preventive measure, but also a treatment. Types of preventive diets aimed at treating urolithiasis have their own characteristics and compliance with the rules:

Let's find out which foods are prohibited to eat if you have kidney stones.

Bread (made from premium flour), baked goods, cakes with rich cream or pastries;
Meat broths, mushrooms, poultry (skin, fat) and soups made from them;
Fatty fish: mackerel, salmon, catfish, herring;
Seafood;
Young poultry meat, high in purines, as well as canned poultry and fish;
Sausages, smoked meats, jellied meat, jelly, jelly;
Legumes, beets, spinach, eggplant (limited), rhubarb, sorrel;
Berries (raspberries and all types of currants, cranberries, as well as gooseberries and lingonberries);
Citrus fruits are rare;
Salty or spicy varieties of cheese are not allowed;
Pickles, canned food, marinades;
Coffee, all types of chocolate, cocoa and strong tea;
By-products that contain fat and purines;
Beef, lamb, cooking fat, bacon, margarine;
Various spicy snacks and spices: horseradish, mustard, all types of peppers;
Egg yolk.

Next, we will look at what foods are allowed to be eaten while following a special diet.

This list includes products that contribute to the alkalinization of urine (with the exception of phosphate stones in the patient, in which, on the contrary, it is necessary to oxidize the urine): vegetables, fruits and dairy products.

Dried bread made from bran or coarse flour;
Summer salad;
Sauerkraut, soaked vegetables;
Pasta and cereals are rare;
Non-sour, sweet fruits and berries help eliminate oxalates;
Zucchini, potatoes, tomatoes and pumpkins, as well as eggplants are rare;
Lean fish, beef and dietary poultry;
Milk, cottage cheese and other fermented milk products;
Lightly salted, mild cheese;
Eggs, but yolk in moderation;
Dried fruits, honey, marmalade, marshmallows, jam and meringues;
Sauce made from tomatoes, cream or vegetables;
Coffee with milk or lemon, weak tea, decoction of wheat, bearberry or oatmeal;
40 grams of butter, and rarely vegetable oil.

Why is it so important to exclude foods from the first list from your diet? Let's find out.

Following a diet if you have urolithiasis is important because:

This is the prevention of the formation of other stones;
Promotes the dissolution of existing stones;
Helps remove formations in the form of salt or small stones from the kidneys.

At the same time, the diet helps to reduce excess weight, improves the functioning of the heart and digestive tract. If you strictly follow your diet, the patient will minimize the risk of urinary tract inflammation.

If you ignore diet instructions if you have stones, there is a risk of complications:

Chronic pyelonephritis;
Chronic urethritis or cystitis;
Kidney failure;
Frequency of attacks.

To prevent these complications from occurring, study the diet for urolithiasis specifically for your specific situation. As mentioned above, stones are of urate, phosphate and oxalate types.

Vegetable salad per plant. oil

(not baked goods), rosehip decoction

milk porridge, lingonberry juice

In addition to the products contained in the menu, you can eat 300 grams during the day. any bread, 20 grams of butter, 40 grams of refined sugar or sugar.

In this program by Elena Malysheva you will learn about the basic principles of a diet for urolithiasis:

Of course, following a diet is very difficult work on yourself, on your willpower, but it is necessary for the benefit of your health. You will feel the ease of your body’s functioning, and you will hardly want to be tempted by forbidden food.

Honestly, I didn’t believe that phytospray would help me lose weight. after all with this problem.

Sports and limiting yourself in calories are the main two factors that can really affect your weight.

I have a friend who suffers from a stomach ulcer, but at the same time wants to lose weight very quickly. Tell.

Of course, if you eat everything in such a minimal amount, you will lose weight. Even during the New Year holidays.

Surgery

When a stone enters the ureter, it begins to gradually move towards the bladder. The diameter of the stone is 3–15 mm. The uneven shape contributes to retention in certain areas of the urinary canal, which leads to blockage.

With small sizes (up to 0.5 mm), it can be removed independently. If the stone is large, you cannot do without surgery. If there is a stone in the ureter, the specialist must determine the optimal method of surgery. The method of disposal through surgery depends on the size of the formation and location in the ducts.

Ways to get rid of stones:

lithotripsy (remote and contact);
surgical intervention to open the ureter.

Any of these methods requires additional drug treatment. The patient takes painkillers, antispasmodic medications, is treated with diuretics and restores water balance.

The urinary tract can become infected when stones move, so the patient is prescribed mandatory antibiotics. The supervising doctor determines which pills to take.

Diet after surgery to remove a stone from the ureter

Stones can be of different shapes and sizes. Large ones are often retained in places where the ureter is narrowed, and smaller ones are excreted in the urine. The cause of occurrence is a violation of metabolic processes.

Urolithiasis can be provoked by exogenous causes: climate, water and soil (which affects the quality of grown and consumed products), living and working conditions. Also one of the reasons is a persistent change in the acidity of urine.

Endogenous factors - infections of the genitourinary system, gastrointestinal diseases, deficiency of certain enzymes and hereditary predisposition.

Removal is carried out in several ways.

Diet therapy is prescribed to patients regardless of the treatment method.

As already mentioned, formations are classified according to their chemical composition. There are certain recommendations regarding nutrition based on this indicator.

The daily diet is designed for 700-800 kcal, 150 g of carbohydrates, 15-20 g of fat and 5 g of protein. Additionally, vitamins are prescribed. The patient is allowed low-fat chicken or turkey broth, rice broth with butter or cream, compote and liquid jelly, natural non-concentrated fruit and berry juices. Dishes with a puree-like consistency, fatty fermented milk products, and carbonated drinks are strictly prohibited.

First meal. Soups contain well-cooked cereals, vermicelli, and vegetables. Fatty meat and fish broths and concentrated vegetable broths are prohibited.
Low-fat varieties of meat, poultry and fish, boiled and baked.
Porridges are boiled in water or milk and pureed. Buckwheat, rice and semolina cereals are used. Vermicelli and pasta are allowed, legumes, pearl barley, wheat, corn and barley are prohibited.
Vegetables - boiled and mashed potatoes, carrots, beets and cauliflower.

During the day, no more than 3 boiled eggs, premium wheat bread, weak tea, coffee, cocoa are allowed.

Nutrition is aimed at restoring the body and increasing immunity. The diet is high in proteins, minerals and vitamins and low in carbohydrates and fats. 5 meals a day are provided.

First courses - any.
Meat, poultry and fish with limited fat content.
All cereals and legumes are boiled.
Any dairy products.

The diet must contain cottage cheese, cheese, raw vegetables, wheat and rye bread.

Removing stones from the ureter: medications and surgery

A study in northern India found that more than 90% of tripel phosphate stones were also composed of oxalates. In a clinical trial from southern Thailand, the most common component of struvite stones was uric acid. An American meta-analysis published in 2011 found that most stones were composed of calcium phosphate (55%), uric acid (21%), calcium oxalate (14%) or cystine (10%). Crystals in the bladder usually result from benign prostatic hyperplasia.

Many urinary stones provoke renal colic, while struvite stones are asymptomatic. This is due to the fact that large tripelphosphate stones are unable to lead to acute dilatation of the ureteral orifice and resulting pain.

Both technical and medical procedures have undergone revolutionary changes in the treatment of urolithiasis. Since about 80% of stones pass spontaneously from the body, often only painkillers and close monitoring by a urologist are required.

The presence of an active and untreated urinary tract infection is a contraindication to stone removal. Antibiotics should be administered prior to surgery in an attempt to minimize the likelihood of sepsis occurring during treatment. Likewise, if there is concomitant bladder obstruction and purulent infection (pyonephrosis), percutaneous drainage and antibiotic prophylaxis should be considered. This helps reduce the risk of postoperative complications.

The most significant advance in therapy has been the introduction of extracorporeal shock wave lithotripsy (ESWT) because the crystal can be fragmented (crushed) without surgery. As a result of ESWT, stone chips are formed, which are easily removed in the urine. The smaller the stones become, the better and easier they are to eliminate.

It is important to know! The success of therapy is monitored by ultrasound or radiography. Treatment may need to be repeated several times, especially for hard and large stones. Even in children, ESWT is the method of choice.

Let's figure out how to remove a stone from the ureter in men and women. Treatment of hard bladder masses mainly involves treating the primary cause. Laparoscopy or open surgery is often prescribed.

Sometimes patients develop very large stones. In this case, there is a risk of ureteral rupture during removal of pathological formations using endoscopic procedures.

Therefore, surgeons resort to abdominal operations. Previously, before the era of endoscopic methods, open removal of stones from the ureter was the only treatment.

About 95% of stones can be treated with minimally invasive therapy. Laparoscopic removal of stones from the ureter in women is one of the safest surgical techniques, which is also often prescribed in medical practice.

In some cases, in the presence of particularly large stones in the urinary canal, surgical opening is resorted to. An operation is performed to remove stones under general anesthesia; an incision is made below the ribs, about 10 cm in size. The doctor performs manipulations through the hole.

The urinary canal is opened, a stone is removed from it, after which the tubular organ is sutured. The operation is quite complex, the outcome directly depends on the experience and professional training of the surgeon. Before opening the ureter, the patient must undergo a set of diagnostic tests:

general analysis (blood, urine);
glucose level;
determination of platelet concentration in the blood.

Given the need for deep anesthesia, an examination by an anesthesiologist will be required. It is also necessary to find out whether the patient has an individual intolerance to any drugs. The patient’s lifestyle, addiction to alcohol or drugs is clarified. Such information is needed to determine sensitivity to anesthesia and establish the correct dosage.

Rehabilitation lasts 14–21 days, recovery after lithotripsy takes 3 days.

Briefly about the causes, factors and symptoms of the disease

The reasons for the formation of stone disease can be both a change in the water-salt balance and changes in the chemical composition of the blood. However, it is necessary to take into account some additional factors that lead to the disease even with normal blood balance and composition:

Pathologies of thyroid function;
Genetic predisposition;
The presence of chronic kidney diseases, the genitourinary system in the form of cystitis, pyelonephritis, gastrointestinal diseases, in particular gastritis, ulcers, joint problems (arthritis, arthrosis);
Lack of sunlight;
Addiction to foods containing a lot of acid: salty, sour, spicy foods;
Too hot climate or prolonged dehydration;
Drinking water with a high salt content (hard).

If there is at least one of the factors described above, you should listen to your condition and note the presence or absence of symptoms indicating the possibility of kidney stones:

dull, intermittent pain in the lumbar region;
periodic presence of blood in the urine after pain or heavy exertion;
constant or variable increase in blood pressure;
cloudy urine;
debilitating periodic lower back pain (in women, not to be confused with PMS);
asymptomatic increase in body temperature;
frequent urination;
swelling.

Stone removal methods

Modern medicine offers several methods for treating pathologies associated with the formation of kidney stones:

Therapeutic treatment is carried out using special preparations and decoctions of medicinal herbs. This technique is effective only if the stones formed are small in size.
Large stones are removed by lithotripsy. This is a minimally invasive technique that involves crushing the formed stones, the particles of which are then removed from the body naturally. The destruction of stones can be carried out using a laser beam or ultrasonic waves.
Surgical removal is rarely performed. The procedure is effective in case of formation of large stones.

Doctors choose the appropriate treatment method based on the patient’s age, the size and composition of the stones, and the presence of concomitant diseases.

Causes of urolithiasis development

Today, surgery to remove kidney stones is not very difficult. However, if the patient does not comply with the rules of postoperative behavior, the consequences can be very serious, including the development of chronic renal failure. Today, laser removal of kidney stones can be done quickly and safely, but this does not eliminate the need to follow a postoperative diet.

For what reasons does urolithiasis develop, why do sand and stones form in the kidney tissues? The reasons for the formation of stone disease can be both a change in the water-salt balance and changes in the chemical composition of the blood. But what are the reasons for these changes? Here is a list of the most common:

endocrine diseases;
genetic predisposition;
presence of chronic kidney disease;
poor diet, alcohol abuse;
some gastrointestinal diseases - gastritis, ulcers, erosions;
disturbance of salt balance in the body;
staying in extreme conditions, accompanied by hunger and lack of water;
regular dehydration for one reason or another;
excess minerals in the diet;
drinking water with high salt content.

How to crush stones in the ureter

To break up stones in the bladder, kidneys or ureter, lithotripsy is most often indicated. The essence of the procedure is to use the most appropriate type of energy impact on the stone in each individual case. Grinding is considered successful if the patient’s condition improves and sand appears in his urine, which indicates the normalization of the body’s urinary function. Lithotripsy happens:

remote;
transurethral;
percutaneous.

The choice of a particular technique is influenced by:

level of complexity of the disease;
localization of stones;
size and physical and chemical properties of the stone;
the patient's desire (not always).

What to do after surgery?

After surgery, the patient must adhere to the recommendations of the nutritionist. All rules are prescribed individually, taking into account the nature of the stones, lifestyle and nutrition of the patient. However, there are a number of general recommendations that facilitate the flow of urine and bile and work as a preventive measure, minimizing the risk of tumors.

Important! After removing stones by crushing, a particularly strict diet is not required, you should only give preference to foods that are easily digestible, so as not to burden the body and kidneys

Most often, patients should avoid marinades, canned foods, smoked foods, and fried foods. You should categorically avoid food containing dyes, soda and alcohol. It is recommended to reduce the consumption of coffee and tea, but leave the total volume of liquid within 1.5-2 liters per day.

Important! In the case of abdominal surgery, a strict diet is required - this is the only possible way to restore body functions. Any violation will entail painful consequences, including the need for a complete transition to a steam diet for the rest of your life.

After removing the stone in a cavity manner, the patient is fed:

The first two days, very liquid food: secondary meat broths, jellies, diluted natural juices without sugar, jelly. Meals are small, frequent, the volume of food taken at one time does not exceed 300 ml.

Important! For the first and second days after surgery, no solid, pureed food is allowed!

Transurethral contact lithotripsy

A minimally invasive method for crushing kidney and ureteral stones is retrograde (transurethral) endoscopic interventions (Fig. 1). The essence of this technique is to pass thin optical instruments (endoscopes) under anesthesia through the urethra, bladder, ureter, reaching the renal pelvis and stone. Thus, the entire procedure takes place under continuous visual control. The optimal stone sizes for these manipulations are from 15 to 25 mm. Having reached the stone, it is sequentially fragmented using various types of energies.

How to cook oatmeal porridge with milk?

Oatmeal with milk is an excellent breakfast for patients after surgery. If the stones were phosphate, then milk from plant components should be used.

Heat 200 ml of milk over low heat, pour 100 grams of oatmeal porridge into a cup.
Stir, add a spoonful of honey, a pinch of salt.
After boiling, stir thoroughly again, cover with a lid and let steep for 5-10 minutes.

How to cook oatmeal porridge with milk if you want variety? Well, you should show your imagination. Adding dried fruits, pieces of fruit (from the list of those allowed for a certain type of stone), cinnamon, vanilla will make the dish unusual in taste and aroma.

Indications for stone crushing

Extracorporeal lithotripsy is used to destroy X-ray positive oxalate, phosphate, urate, cystine urinary stones measuring 5 mm–2.5 cm. Percutaneous crushing is performed when coral, calcium stones larger than 2 cm in size are confirmed in the kidneys, or if urethral insertion of the device is impossible due to tumors, narrowing of the ureter . The contact method is used for single or X-ray negative formations up to 2.5 cm.

Lithotripsy is indicated if there is a risk of:

urosepsis;
nephrosis;
pyelonephritis;
disturbances in the outflow of urine.

On a note! It is necessary to crush stones larger than 4 mm, even if they do not bother you. Such stones do not come out on their own; they become overgrown with new salt deposits. Later they become the cause of renal colic, ureteral blockage, and pyelonephritis.

Nutrition depending on the type of stones removed

The chemical composition of blood and urine salts determine the characteristics of urolithiasis, that is, the composition of the stones. Depending on this, nutrition is prescribed after a kidney stone is removed. It is especially important to pay attention to the liquid consumed by the patient, in particular, to mineral water: not every mineral water is useful, some types can provoke neoplasms! You should check with your doctor about the type of useful mineral water.

The formation of stones in this group occurs due to the accumulation of uric acid salts, so it is extremely important to limit foods containing purines and uric acid salts:

Seafood in the form of mussels, scallops, oysters;
Beef and goose liver;
Kidneys, brains;
Spinach, sorrel, beans, Brussels sprouts;
Tea coffee.

You should not completely exclude foods from your diet. There are no restrictions on other products; mineral water is indicated as alkaline.

The formations depend on the degree of disturbance of phosphorus-calcium metabolism, while urine is more alkaline in nature, so nutrition should minimize foods rich in calcium and phosphorus:

Fermented milk and dairy products (except sour cream);
Fish, canned fish;
Egg yolks;
Pickles;
Smoked meats;
Nuts, seeds;
Fruits, berries.

Vegetables recommended for consumption: peas, pumpkin, asparagus. Fruits: apples, prunes, currants. Meat products and fish, vegetable fats, cereals without restrictions. Mineral water Narzan.

Stones are formed due to excess oxalic acid, so it is better to completely eliminate this substance from the diet. You should refuse:

Sorrel, spinach, lettuce, rhubarb, beets, carrots, zucchini;
Oranges, lemons, blueberries, raspberries, blueberries, currants, gooseberries;
Coffee, tea, cocoa – limit;
Chocolate, nuts, beans – limit.

Important! Regardless of the characteristic composition of the removed stones, it is necessary to get rid of excess body weight. Excess fat causes imbalances and metabolic processes in the body.

Possible options for the procedure and their features

A patient’s admission to the clinic’s inpatient department indicates the presence of symptoms of urolithiasis, so doctors immediately carry out diagnostic procedures. Indications for performing the crushing procedure are the identification of a stone measuring 0.5-2.5 cm, acute renal colic, as well as an inflammatory reaction in the body caused by the presence of stones.

Despite the fact that lithotripsy sometimes becomes necessary and the only way to eliminate dense structures, there are a number of contraindications for its implementation. It should not be used if the patient has the following abnormalities:

unsatisfactory coagulogram results;
abdominal aortic aneurysm;
extensive kidney cyst;
acute infections of the genitourinary system;
tumor formation of a malignant nature.

Attention! Removing stones is not recommended for women during pregnancy, breastfeeding, as well as when calculi in the form of coral, bone changes are detected, when installing a stent and a heart pacemaker.

Since the procedure has been performed for a long time and specialists have many years of experience in performing it, complications are rare. However, after lithotripsy, the formation of a hematoma or blockage of the ureter with small fragments with subsequent development of inflammation is possible.

In rare cases, undesirable consequences may occur:

damage to the mouth;
perforation;
ureteral avulsion;
migration of stone to the kidney.

If complications occur, the paired organ is drained and a course of antibacterial therapy is administered. The risk of side effects increases with repeated interventions, since the topography of the retroperitoneal space changes significantly due to scar formation.

Complications with contact lithotripsy may include:

acute purulent, obstructive or reflux pyelonephritis;
ureteral strictures;
recurrent renal colic.

Common postoperative conditions are:

presence of blood in the urine;
pain in the abdomen or kidney area;
flatulence;
problems with stool;
nausea, vomiting;
changes in blood pressure;
increase in body temperature.

All these conditions can be easily eliminated with an adequate and timely approach, attention from medical personnel and correct behavior of the patient.

To minimize discomfort and eliminate discomfort, patients are prescribed litholytic drugs - “Canephron”, “Fitolysin”, “Cyston”.
To eliminate spasms, drugs are recommended - “No-Shpa”, “Baralgin”, “Drotaverin”.
To stop and eliminate the inflammatory process, NSAIDs are prescribed - Diclofenac, Nimesil, Ibuprofen.

Rehabilitation after the stone crushing procedure consists of eliminating side effects, restoring urine passage, and normalizing the function of the urinary system.

Medicinal method of dissolving stones

If for some reason lithotripsy is contraindicated for the patient, the doctor may prescribe treatment with drugs to dissolve and remove stones. Depending on the composition of the stones, various means are selected:

oxalates – “Prolit”, “Marelin”;
phosphates – madder extract;
urates - “Allopurinol”, “Etimide”, “Blemaren”, “Remid”, “Zilorik”.

Cystine stones are formed from uric acid, so it is recommended to use sodium bicarbonate or soda to remove them. It is considered an alkaline agent, which, when interacting with microlite, completely dissolves it. The use of potassium citrate is also often prescribed.

Operational

This method is used infrequently, only in extreme cases. Surgical treatment of urolithiasis is recommended in the following situations:

the diameter of the ureteral stone exceeds 10 mm;
gross hematuria;
high risk of developing renal failure;
location of the stone in the distal ureter during a 4-6 week course of therapy.

Common and popular types of surgical intervention include:

endoscopy – removal of stones using endoscopic equipment;
open type surgery (cavitary) - removal method through an incision in the kidney.
resection – partial removal of a part of a paired organ or its share.

All operations are conventionally divided into urgent (emergency) and planned. Depending on the location of the stone, urgency is determined and the following types of procedures are distinguished.

Pyelolithotomy is an operation to remove stones from any part of the ureter. It is performed under general anesthesia.
Nephrolithotomy is a method of removing microliths, similar to the previous one.
Cystolithotomy is a common method to remove a large stone from the bladder. It is considered one of the most traumatic operations for ICD.
Ureterolithotomy is a surgical operation to remove a stone from any part of the ureter. Depending on the location, access is performed in different ways.

Common to all types of surgical intervention is damage to soft tissue in order to gain access to the organ. The postoperative period lasts from a couple of weeks to a month.

Non-surgical

This method is used in the initial stages of the development of urolithiasis, when the stones have not acquired a dense structure, but are in a jelly-like state. Medicines, traditional therapy, and ultrasound can be used here. The doctor selects the most optimal option based on diagnostic data.

Diet and folk remedies

Traditional medicine methods, which can be used after consultation with a doctor, are no less popular.

The following products have an excellent effect:

olive oil;
decoction of birch buds or leaves;
juice from sauerkraut;
a mixture of juices from carrots, beets, cucumbers;
infusion of lingonberry leaf.

It should be remembered that treatment according to the recipes of traditional healers is a long process, so the result may occur after 1-2 months. Proper nutrition plays an important role, which involves drinking enough liquid per day, reducing salt and eliminating foods that contribute to the formation of stones.

What symptoms should you pay attention to?

If you notice the following symptoms, you should visit a nephrologist or at least take a biochemical blood test (particular attention should be paid to creatinine and urea levels):

the presence of blood in the urine, changes in the amount or consistency of urine excreted;
periodic dull pain in the lumbar region, usually only on one side;
presence of sediment in the urine;
low-grade body temperature of about 37 degrees;
increased swelling of the limbs and face;
pain when urinating on one side of the lower abdomen (less often, on both sides at once).

The kidneys are a paired organ whose tissues have few nerve endings. Therefore, they themselves rarely hurt. If pain does appear, then we can talk about an inflammatory process in the tissues (pyelonephritis, glomerulonephritis). If small stones pass on their own, the patient feels a sharp pain in the area of the ureters (lower abdomen), and urine is released painfully and in small portions. If you suspect that a stone is passing, it is better to call an ambulance - independent removal of stones does not always end well.

Depending on your age, lifestyle, and gender, the symptoms of kidney stones may vary slightly. Treatment for women and men is the same. It should be taken into account that the more bad habits a patient has, the more physically tired he is at work, the more pronounced the signs of an incipient pathology may be. In some cases, surgery is the only treatment option. Symptoms of kidney stones in women can worsen during premenstrual syndrome (swelling increases, lower back pain forces you to take painkillers). Men don't have this problem.

Contraindications to lithopripsia

Crushing stones in the ureter is not always possible. Regardless of the type, such procedures have a number of contraindications, the list of which is as follows:

coral-shaped stones;
pregnancy;
various blood clotting disorders;
the patient has a pacemaker;
abdominal aortic aneurysm;
the presence of large cysts in the kidneys;
acute infectious diseases, such as colds or acute respiratory viral infections (in this case, you first need to undergo a course of treatment);
pathological changes in bones;
oncological diseases.

What can you eat after surgery to remove stones for effective treatment?

In the postoperative period, the diet should consist of the following products:

In the first two days after surgery, patients are prescribed liquid food (low-fat meat broths, jelly, jellies, natural diluted juices without sugar, etc.). The volume of each serving should not exceed 300 ml.
On the third day, pureed soups and porridges, natural liver pates, hard-boiled eggs, slightly dried bread, non-acidic vegetables, berries and fruits (including in the form of jam, juices and jellies), as well as tea with milk and homemade compotes are allowed.
On the fourth day there are no strict dietary restrictions. You just need to avoid fatty and fried foods.

List of prohibited foods and drinks

If the patient wants the kidneys to work properly, so that an inflammatory process does not develop after the operation, so that stones do not form again, the following foods and drinks should be avoided:

sausages, snacks, aspic, canned food and other dishes with a high fat content, in which preservatives, herbs and spices were added in large quantities;
fast food, fried potatoes, fried cutlets and other dishes, the preparation of which involves frying and adding a large amount of fat;
depending on the type of stones, a permanent ban may be imposed on certain types of vegetables and fruits;
you will have to significantly limit the amount of coffee and chicory consumed;
Sugary carbonated drinks are prohibited;
any alcoholic drinks, regardless of strength and quality.

Consequences of crushing kidney stones (from a reader)

The consequences of crushing kidney stones personally took me by surprise. My name is Tatyana, I am 45 years old, I am married, I have two children. Like many who sooner or later faced the problem of stone formation, I learned that stones form in the human body, including in the kidneys.

From the point of view of doctors, this process does not have a clear explanation, since it is usually referred to as a complex problem of stone formation. The main thing in this regard is not to forget that the consequences of crushing kidney stones can negate any treatment that doctors in ordinary hospitals will offer you.

I still can’t understand just one thing, it’s obvious that doctors know all the consequences of one or another crushing of kidney stones, why then don’t they tell the patients themselves about them? These questions force you to draw the unpleasant conclusion that the nice and smiling doctor in your hospital knows exactly how you will suffer in the future by prescribing certain methods.

I can also also say that after I saw the various real consequences of crushing kidney stones on myself, I have something to say and write to people.

At first, I did what the doctors advised me three times, and only when I realized that they were either, to put it mildly, ignorant or blatantly deceiving, I tried innovative stone crushing. The dissolution was quite gentle and painless. After using this method, the stones did not appear again.

My story is probably no exception, it’s just that the consequences of crushing kidney stones in other patients are not made public due to simple laziness. Writing a review and sending it to the site is not easy, especially since there are usually so many things to do around the house that you can’t do them all.

Transurethral or contact crushing

Stones can also be destroyed by introducing into the urethra a special flexible endoscopic instrument called a ureteroscope. In these cases, the energetic impact is “delivered” directly to the stone, which is crushed into very small particles and then either removed with the same instrument or removed through urination. Each manipulation of the endoscope is controlled visually, since there is a light bulb and a video camera at the end of the flexible instrument. The progress of each operation is recorded on video. Such interventions, like remote ones, are carried out under anesthesia.

Laser crushing can destroy a stone into many fragments in one step

With the transurethral method, the size of the stone does not matter. Exposure to ultrasound or laser, used as a destructive impact force, can break stones up to 3 cm in size into small fragments. Complete destruction of stones can be achieved in one operation. In this case, the healthy tissue of the ureter surrounding the stuck stone is not injured. This means that after contact crushing the risk of urinary tract infection is eliminated. Therefore, patients are discharged from the hospital after 1-2 days without disability.

Laser or ultrasound transurethral stone destruction are the most modern methods of treatment today. They are rightly called the “gold standard” due to their high efficiency, low invasiveness, absence of relapses and side effects.

First two days

After abdominal surgery, a strict diet is necessary. It is similar to that shown when removing stones from the ureters. The composition and volume of food are strictly regulated and depend on the period elapsed after surgical treatment. So, in the first two days, a special diet is required after removal of No. 0a, which is observed for no more than 3 days.

The basis during this period is warm liquid food:

Meat broths: chicken, turkey;
decoctions of rose hips, rice with butter, etc.;
teas;
natural juices, etc.

Whole milk;
soda;
fatty foods, etc.

The purpose of this regime is to maximize the load on the digestive organs. This is also achieved through:

Fractional doses: every 2 hours;
small quantities: no more than 300 g at a time.

The patient should receive approximately:

700-800 kcal;
15–20 g fat;
150 g carbohydrates;
5 g proteins.

Non-surgical treatment

Removing stones from the ureter does not always require surgery. In the presence of small stones in the ducts, conservative treatment, including taking medications and following a diet, is very effective.

Drug therapy does not always bring the desired result. Often, taking medications has only a symptomatic effect - it relieves pain and spasms, thereby relaxing smooth muscles, facilitating the release of small stones.

In the presence of inflammation, the diseased kidney works intermittently, which affects the general well-being of the patient and severe symptoms appear. A bacterial infection often occurs, which requires the use of antibiotics and antimicrobials.

Drug treatment may include the following medications:

painkillers;
antispasmodics;
diuretics;
urolitics;
antibiotics.

Medicines can be prescribed in the pre- and postoperative period. The choice of any medicine, dose, duration of use is determined by the doctor individually for each patient.

Diet after surgery

The diet for stones in the ureter includes foods that reduce the risk of recurrent stone formation. The following should be excluded from the diet or minimized consumption:

sorrel;
spinach;
white cabbage;
nuts;
parsley;
currants;
high fat dairy and fermented milk products;
fatty meats.

Taking such products will help re-form stones or stimulate their growth.

Fasting days will be beneficial in the postoperative period. It is recommended to drink up to two liters of liquid per day. For ICD, rosehip decoction, herbal teas, black radish juice, and birch juice will be useful. The doctor will be able to give useful advice on nutrition after surgery, based on the composition of the stones and the patient’s age. The diet after stone removal is prescribed for several weeks or months.

Removing stones using laser

Laser crushing of stones in the ureter is another effective and safe procedure. During the operation, an endoscope is inserted into the renal pelvis, which allows the specialist to get a good overview of the stones. Using a laser, the doctor destroys solid formations - they disintegrate into small parts. Today there are devices that can destroy even the smallest grains of sand.

Crushing stones in the ureter with a laser does not take much time and does not require general anesthesia - the patient is given only light sedatives. The punctures on the skin are very small, and there is no direct contact with the patient’s blood, which minimizes the likelihood of tissue infection. The laser acts directly on the stone without damaging the tissues of the excretory system. After the procedure, the patient's condition is monitored for several hours, after which he can go home. Rehabilitation does not require much time - a person can return to their normal lifestyle almost immediately.

Dietary first courses

Soups are hearty and healthy food. You can significantly diversify your diet if you study recipes for pureed vegetable soups. This is a low-calorie and healthy dish that is quickly absorbed and does not cause exacerbation of chronic kidney diseases.

An important point: patients with oxalate stones are prohibited from adding carrots, spinach, legumes, and zucchini to soups.

A simple recipe for pureed vegetable soup:

Peel, rinse and chop into cubes three medium-sized potatoes, 100 grams of chicken fillet, one onion, one carrot (if carrots are allowed on the diet - for example, patients with oxalate stones are not allowed to eat them).
Boil vegetables and pieces of meat in a liter of boiling salted water for 20 minutes.
Do not drain the broth. When the mixture has cooled, pour it into a blender and beat until smooth.
Reheat slightly over medium heat. Serve the soup hot and fresh; when reheated after refrigeration, it will no longer be tasty. You can add herbs, wheat bread crackers, and bell pepper rings to taste.

Rehabilitation period

The duration of the rehabilitation period depends on the severity of the removal. During the first time of the recovery period, the patient may experience discomfort or pain, swelling of the soft tissues and an increase in body temperature. These consequences are most characteristic of surgical methods of intervention.

After surgery, it is recommended to follow a gentle regimen for the body: do not engage in physical labor, do not suffer from acute respiratory infections or acute respiratory viral infections, and also adhere to the schedule of control ultrasound scans. As a rule, the intervention process itself, as well as the rehabilitation period, is more difficult for men than for women. However, following your doctor's recommendations will help avoid complications.

The content of rehabilitation is not only to restore the functioning of the body, but also to change lifestyle to eliminate the original problem that contributed to the formation of stones. It is important to understand that procedures and operations aimed at removal are aimed at relieving the patient of the symptoms that have arisen. They cannot treat the underlying problem.

Depending on the composition of the stone, the patient is prescribed an individual diet that excludes foods that are harmful for a particular case. Excessive consumption of certain foods from the regular diet contributes to the accumulation of salt substances in the urinary system. In addition, their retention in the body occurs due to insufficient fluid intake during the day.

Also, the formation of stones is affected by some functional disorders in the body: gout, hyperthyroidism and others. Therefore, it is necessary to undergo a full examination and therapy to eliminate these diseases. Next, the patient will expect periodic monitoring of the functioning of the urinary system for possible detection of newly formed stones.

It should be remembered that the lack of timely diagnosis and treatment will cost the patient serious health problems in the future. Numerous Moscow clinics provide stone removal services in various ways and at appropriate prices. However, the price may be increased if the patient has to recover after the intervention within the walls of a medical institution.

After removing stones from the ureter, the patient needs to:

Take a course of antibacterial therapy.
Follow a dietary diet.
Take diuretics.
Increase the amount of fluid you drink per day.
Reduce physical activity.

When an endoscopic operation is performed, the body recovers quite quickly, but a person still needs to monitor his diet and health, and periodically undergo an ultrasound, which can promptly detect the re-formation of stones in the urinary system. If you follow all the doctor’s recommendations, the risk of complications and relapses of the disease will be minimized, and the patient’s body will recover much faster.

After removal of the stone, the patient needs to restore the functioning of the urinary organs, for this he should:

drink a lot of water (2.5 liters);
use diuresis stimulants;
adhere to a special diet (table 0);
use diuretics.

The formation of stones is the result of metabolic disorders in the body. Therefore, the patient should completely reconsider his lifestyle and preferences in order to avoid the formation of new stones.

Features of the preoperative diet

Nutrition in the preoperative period is based on the general principles of diet therapy for urolithiasis:

prevention of precipitation of salts (better dissolution) by correcting the reaction of urine to the alkaline/acid side by changes in the nature of nutrition;
limiting the consumption of substances that contribute to the formation of kidney stones;
removal of salt deposits due to abundant drinking regime.

The influence of diet and mineral water therapy helps to normalize metabolic processes, which are the main cause of stone formation.

Nutrition after phosphate stone removal

The formations depend on the degree of disturbance of phosphorus-calcium metabolism, while the urine is more alkaline in nature. Nutrition for a patient with phosphate stones includes the following restrictions:

fermented milk products (except low-fat sour cream);
any varieties of fish and seafood in the form of canned food;
the yolk of a chicken egg is also prohibited;
nuts, seeds.

It is permissible to consume varieties of fish that contain a minimum amount of phosphorus, and only in stewed or boiled form. When choosing vitamin-mineral complexes, preference should be given to those in which phosphorus is completely absent or its amount is insignificant.

Efficacy of the procedure and prognosis for recovery

Shock wave extracorporeal lithotripsy for adults is considered the least effective in crushing dense stones. Fine salt deposits disintegrate during the first session. To grind large or too hard stones, more than 2 procedures are often required. Complete destruction of such formations is achieved through the combined action of ultrasonic waves and taking medications that dissolve salt crystals.

High efficiency in urethral lithotripsy. Formations of medium hardness are destroyed the first time, since ultrasound contacts directly with the stone. The stones disintegrate into a sand fraction and are washed away by a stream of urine. It is recommended to crush salt deposits that are too dense with a laser lithotripter.

Important! Regardless of the lithotripsy method, relapses of urolithiasis in the first 5 years occur in at least 50% of cases. Complete recovery is possible by giving up bad habits, following a diet and treating the pathology that caused urolithiasis.

Postoperative complications

After lithotripsy, the formation of a renal hematoma is possible during the treatment of nephrolithiasis. When multiple stones are destroyed, there is a blockage of the ureter or urethra with fragments. Remains of large stones provoke relapse of urolithiasis. The presence of infection in the body causes complicated inflammation of tissues damaged by the shock wave.

Urine mixed with blood during the recovery period does not apply to complications if hematuria occurs due to microtrauma of the renal parenchyma, the wall of the ureter by a shock wave or a fragment. The norm is moderate pain, body temperature up to 37.3º C, change in urine color, excretion of stone fractions, and frequent urination.