Currently, urolithiasis is one of the most common pathologies. According to statistics, 50% of patients who seek help from a specialist suffer from this ailment. In cases where conservative methods of treatment are powerless, the doctor decides to perform an operation to remove stones from the bladder. In medical language, this surgical intervention is called cystolithotomy.
Urolithiasis: causes, symptoms
This pathology can occur in people of any age. The disease is characterized by the formation of stony compounds in the bladder, kidneys or ureters.
At present, there is no single picture of the mechanism of development of the disease, and the reasons for its occurrence are not fully understood.
Nevertheless, it is proved that the triggering factors for the development of the disease are:
- inflammatory processes in the organs of the urinary system;
- taking certain medications;
- unbalanced diet;
- irregular physical activity or lack thereof;
- low quality of water used;
- deficiency of vitamins A and group B;
- adverse working conditions;
- metabolic disorders;
- chronic diseases of the digestive system;
- dehydration;
- congenital malformations of the kidneys and bladder.
In each patient, the disease proceeds differently. Someone forgets about it after removing stones from the bladder, for someone it takes a chronic character with periods of exacerbation.
The main symptoms of pathology are:
- Renal colic, manifested in the form of intolerable pain. It is localized mainly in the lumbar region and does not disappear after a change in body position. It can also occur in the lower abdomen and give to the groin area.
- Feeling sore or burning when urinating.
- Elevated body temperature.
- Turbid urine, often mixed with blood.
At an early stage, the disease can be asymptomatic. As a rule, in this case, calculi are detected by chance during a routine medical examination. Depending on their type and size, the doctor prescribes either conservative methods of treatment, or gives a referral to the hospital where the surgery will be performed.
Indications and contraindications for cystolithotomy
Removal of stones from the bladder in an operative manner is prescribed, mainly, with the ineffectiveness of drug therapy.
In addition, indications for surgery are:
- Acute urinary retention. This is a condition in which strong urges worry, but a person cannot empty the bubble on his own.
- An increase in the number of red blood cells in urine.
Surgical intervention is not performed if there are violations of the urethra (in men) or infectious diseases of the bladder. Also contraindications are pregnancy and the presence of neoplasms on the organ.
Preparation
Before the operation to remove stones from the bladder, you need to pass urine and blood for analysis.
In addition, it is necessary to undergo the following types of studies:
- Ultrasound of the bladder triangle. This is a site located in the area of the bottom of the organ. It has great diagnostic value, since it is in this zone that inflammatory processes often develop.
- Spiral CT. One of the most informative research methods. With it, the doctor gets a complete picture regarding the structure of the bladder and all existing diseases of the organ. The essence of the method is layered scanning, the result of which is a two- or three-dimensional image.
- Intravenous pyelography. Allows you to evaluate the degree of kidney function. To do this, a special substance is administered to a person, after which a picture is taken using X-ray equipment.
If, according to the results of all studies, contraindications are not identified, the patient is sent for surgery.
Transurethral cystolithotomy
This method of removing stones from the bladder is one of the endoscopic methods of intervention. It is considered the most sparing and is most often applied in practice. Its essence is as follows: the operating channel of the cystoscope (it can be a looped or basket-like type) is inserted into the bladder, captures small stones and displays them out.
Large stones must first be crushed. This process is called cystolithotripsy.
It can be of 2 types:
In the first case, not only a cystoscope, but also a lithotripter is transurethrally inserted. It acts on the stone with an energy flow, crushing it into the smallest parts, which are then easily removed from the organ.
Remote cystolithotripsy is less commonly used in practice due to the low efficiency indicator. It is carried out as follows: the apparatus is placed outside the human body, after which the process of generating a shock wave, which affects only stones, does not have a negative effect on soft tissues, is started.
Removal of bladder stones in both men and women is done through the urethra.
An open method for cystolithotomy
A cavity operation is a surgical intervention that is prescribed in cases where there are large calculi and cannot be crushed and removed using a cystoscope.
After general anesthesia, the surgeon makes an incision with a scalpel in the area above the pubis. As soon as access to the bladder is obtained, the doctor opens it. This is also done through a cut. After examining the cavity of the bladder, the surgeon removes the stones, and then sutures it and the wound.
The open method is considered the most aggressive. After surgery, involving the removal of stones from the bladder, both women and men can experience complications. To reduce the likelihood of their occurrence, it is necessary to contact only trusted medical institutions with highly qualified specialists.
Rehabilitation period
After removing stones from the bladder, each patient receives recommendations, following which can reduce the recovery time to a minimum. In addition, the likelihood of complications is reduced.
The following recommendations are standard:
- Drink plenty. The fluid entering the body rinses the walls of the bladder and helps to remove the smallest particles of stones if they were crushed.
- Lack of physical activity. It is necessary that the walls of the bladder and abdomen strengthened. The day after the operation, you are allowed to walk for several minutes along the hospital corridor.
- Diet. The diet should consist only of those foods that are easily digestible. Cooked meals should be liquid or mashed.
Subject to these recommendations, the recovery period is significantly reduced.
Possible complications
After any surgical intervention, there is little chance of negative consequences. After removing the stones, the function of the bladder may be impaired. As a rule, this manifests itself in the form of difficulty urinating. It worries for a short time, but in some cases it can become protracted.
Other possible complications:
- bleeding (it can appear both immediately after the operation, and after a few days);
- infectious diseases;
- hernia;
- fistulas;
- urosepsis.
When any of these conditions appears, drug therapy is indicated. If it does not bring visible results, an urgent operation is indicated.
It is worth noting that more often complications occur after the intervention in an open way.
Cost
The operation is carried out both in public hospitals and in private clinics. Regarding how much it costs to remove stones from the bladder, you need to check with the selected institution. In some state hospitals, abdominal surgery is performed free of charge (if there is an insurance policy) or at a minimum cost (about 1 thousand rubles). The average price for removing stones from the bladder in Russia is 15 thousand rubles. In most cases, the operation is carried out transurethrally.
Finally
If stony compounds are found in the patient's bladder, the doctor prescribes medication. If therapy does not bring the desired result, surgical intervention is indicated. Stone removal is carried out in two ways: open and transurethral. The latter is more preferable since the operation is less traumatic. The likelihood of complications is also minimized. A cavity operation is performed if the stones are too large and cannot be crushed.