The cause of periodic, sharp painful sensations in the side may be a stone in the ureter. This situation is observed with urolithiasis, the exit of stones. Pathology can lead to a violation of the outflow of urine, which causes a particular clinic.
Urolithiasis - what is this in women?
The disease, in which stones are found in the ureter in women, unlike other localizations of calculi (kidneys, bladder), is characterized by dangerous complications. Due to a violation of the normal outflow of urine under its action, a gradual loosening of the mucous membrane of the ureters occurs. As a result, bleeding occurs in the submucosal layer, which causes hypertrophy of the muscle tissue, a violation of the process of urination. These changes are accompanied by urolithiasis .
Prolonged absence of therapy leads to the progression of the disease, atrophy of the nerve and muscle fibers, a decrease in the muscular tone of the ureters and the bladder. Often when the mucous membrane is damaged, the stone in the ureter provokes the infection: pyelonephritis, cystitis develops. In place of a long-standing concrement, a decubitus is formed, and perforation of the walls takes place, which requires urgent surgical intervention.
Stone in the ureter - reasons
Stones in the ureter appear as a result of their migration from the bladder or kidneys. They have different shapes and sizes, their structure and composition may differ. Often in the ureter, single stones are stuck, in places of physiological constriction - the pelvic-ureteric segment, with a cross with iliac blood vessels. According to observations of doctors, in the ureter stones are retained, the diameter of which is more than 2 mm.
The causes of the formation of stones in the ureters are directly related to urolithiasis. The formation of concrements is facilitated by the same factors:
- malnutrition;
- poor quality of drinking water;
- infectious diseases of the genitourinary system ( pyelonephritis , glomerulonephritis );
- incomplete emptying of the bladder.
Often, urolithiasis occurs against a background of diseases accompanied by a violation of urate, phosphate and oxalate metabolism:
- gout;
- osteoporosis;
- injuries of the musculoskeletal system.
Stone in the ureter - symptoms
Small concrements, not overlapping the lumen of the ureter, may not manifest themselves for a long time. Urolithiasis, the symptoms of which are outside the aggravation are hidden, may not disturb the patient for a long time. In some cases, women with partial overlapping of the ureter mark pains of a dull character. When there is a violation of the outflow of urine, which provokes a stone in the ureter, the symptoms in women acquire a pronounced character:
- sharp sudden pain in the corresponding costocholic-ileal corner;
- nausea;
- vomiting;
- flatulence;
- stool retention;
- muscle tension of the front wall.
This symptomatology is characteristic of renal colic. It develops as a result of disturbance of microcirculation and kidney tissues. This entails irritation of the nerve endings, which causes a severe pain attack. More often its development is associated with physical stress, walking, riding on transport - the stone in the ureter changes its position. In some cases, the appearance of renal colic can provoke a plentiful drink.
Stone in the ureter - diagnosis
Women who suspect this disease, are interested in doctors, whether ultrasound is visible in the ureter. Doctors notice that this method of diagnosis is the main way to confirm the violation. With ultrasound diagnosis, doctors are able to visualize, determine the location of concrements, whose diameter is more than 1 mm. To expose ureterolithiasis, the symptoms of which may be absent, additional diagnostic methods are used:
- general urine analysis (determine the level of erythrocytes, leukocytes, protein);
- blood biochemistry;
- bacteriological culture;
- X-ray examination;
- urethroscopy;
- CT of kidneys.
The stone is stuck in the ureter - what should I do?
This situation is accompanied by severe paroxysmal pains, so the first symptoms should be called an ambulance. The treatment algorithm is developed according to the results of the studies. Before the stones in the ureter are crushed, the doctors determine their exact location, diameter, quantity. With the size of the stone in the ureter 2-3 mm, doctors can take expectant management, prescribing drugs that promote the excretion of concrements from the genitourinary system (stone in the left ureter). To this end, the ureter is injected with:
- Papaverine;
- Glycerol;
- Procaine.
Crushing of stones in the ureter
Reducing the size of the stone allows the painless removal of its particles outward. The crushing of stones in the ureter by ultrasound is a common technique. In addition to it, other methods can be used:
- laser lithotripsy;
- electrohydraulic lithotripsy.
Remote lithotripsy with ultrasound is the simplest and painless technique. At the same time, a high frequency wave is projected onto the ureter's area where the stone is located. Under their influence there is a disruption in the structure of the stones, which break up into parts. As a result, through time, there is an independent exit of the parts of the calculus outward along the urinary tracts.
How does a stone come out of the ureter?
The stone in the lower third of the ureter often causes dysuric disorders. Their severity is enhanced by the migration of the calculus. Patients develop frequent, almost uninterrupted urge to urinate. They are accompanied by a feeling of strong pressure in the area above the pubis, which are caused by irritation of the bladder receptors. In 80-90% of cases, a stone in the mouth of the ureter provokes macrohematuria - the appearance of blood in the excreted urine. With a small diameter of the stone after its exit, the attack stops itself.
Indications for surgical treatment for urolithiasis
If a woman has not one stone in the ureter, medication treatment rarely gives a result. Doctors in this case resort to surgical intervention. The technique of surgical intervention is determined on the basis of clinical manifestations and the patient's condition. The main indications for the operation are:
- Stones with a diameter of more than 1 cm.
- The presence of an infection that does not lend itself to antibacterial therapy.
- Heavy, unrestrained attack of renal colic.
- Obstruction of a single kidney.
- No effect on lithotripsy.
Operation to remove a stone from the ureter
When the operation is performed, the stone in the ureter is removed by direct access to it. Often, surgical intervention is appointed in the case of complete closure of the urethra if the stone is stuck in the ureter, with infection or inflammation of the urinary tract. The operation is performed under general anesthesia, laparoscopy. After the opening of the retroperitoneal space, the surgeon removes the stone and checks the patency of the urine. If it is impossible to reach the calculus without damaging the organ, remove the stone from the ureter after moving it into the bladder.
Diet with urolithiasis
With the diagnosis of urolithiasis, treatment begins with a correction of the diet. As noted above, some products contribute to the formation of new stones and their further growth. From the diet must necessarily exclude products containing oxalic acid:
- cabbage;
- spinach;
- parsley;
- currant;
- sorrel.
In this case, increase the number of products containing vitamin A (carrots, pumpkin). It is important to monitor the volume of liquid being drunk, consuming at least 2 liters of liquid per day. This helps to reduce the concentration of urine, eliminates the accumulation of salts in the kidneys. Cookery salt is tried completely to exclude from the diet in order to facilitate your well-being and speed up the process of therapy.