- Management of the acute episode of renal colic;
- The use of pharmacological or surgical treatment.
For further information: Medicines for the treatment of kidney stones
If the stone does not obstruct the urinary tract, drug therapy is based on the use of diuretics and urinary tract disinfectants to ward off any infections. Uric acid kidney stones have the favorable characteristic of dissolving completely by alkalinizing the urine with medical therapy, without having to resort to surgery. Conversely, those of cystine, very rare, often cause complex, voluminous, very hard and difficult to treat formations.
To control the pain caused by renal colic it is possible to resort to pharmacological therapy. Therefore, analgesics or antispasmodics are administered intravenously , waiting for the spontaneous expulsion of the stone which must move from the ureter into the bladder . The drugs reduce the contractility of the smooth muscles, therefore facilitating the progression of the stone towards the outside.
If spontaneous expulsion is not possible, surgery is performed to remove the kidney stones or crush them.
Which Drugs Are Useful For Colic From Kidney Stones?
Remedies For Renal Colic
Since the pain of colic is due to the spastic contraction of the smooth muscles which thus attempts to overcome the obstruction, it is possible to alleviate the pain by immersing yourself in a tub filled with almost boiling water. In fact, heat has a powerful vasodilatory effect, promoting muscle relaxation. However, such dives should be avoided in the presence of blood in the urine since the antispasmodic properties of the heat would favor bleeding .
Smaller stones may pass spontaneously. In this case, it is first of all expected:
- Rest ;
- Modification of the dietary regime ;
- Increased daily fluid intake .
The latter approach involves the daily intake of high quantities of low-mineral water, but with caution, to cause urine excretion of more than 2 liters over a 24-hour period. This type of therapy is called hydropinic. By thus increasing the volume of urine, the body is encouraged to spontaneously expel small kidney stones and their progressive growth is prevented. Generally, in the case of small stones, up to 5-7 mm, the spontaneous expulsion process can take approximately 2 to 15 days.
What Does The Hydropinic Treatment Of Kidney Stones Consist Of?
Lithotripsy And Surgical Intervention
Kidney Stones: What Are The Surgical Options?
Stones that fail to proceed into the ureter must undergo surgical treatment. It is possible to use different techniques, the choice of which naturally depends on the characteristics, size, location and number of calculations.
- EXTRACORPOREAL LITHOTRIPSY : consists of the fragmentation of small stones from outside the body, which are subsequently eliminated in the urine. This therapeutic method is clearly minimally invasive and is mainly used for some calcium oxalate stones , struvite stones and uric acid stones. In contrast, cystine stones and calcium oxalate monohydrate stones do not respond well to the extracorporeal technique, so they are generally removed with percutaneous or transurethral lithotripsy;
- PERCUTANEOUS RENAL LITHOTRIPSY : it is performed through a hole at the lumbar level through which you enter with an instrument that allows the destruction of the stone and the aspiration of the fragments;
- URETHRORENOSCOPY (endoscopic urethral lithotripsy) : another solution is endoscopic removal. In practice, thin probesare introduced through the urethra , along the urinary tract, to reach the point where a small stone has stopped, to mobilize it and make it descend into the bladder. An endoscopic method, which can always be performed by penetrating through the urethra and ascending from the bladder to the ureter, is ultrasonic ureteroscopy. This procedure allows you to get to the stone and break it into fragments, which can then be eliminated together with the urine or removed with small forceps or “baskets”.
- Open SURGICAL TREATMENT : in cases so complex that the endoscopic approach is not recommended, it may be necessary to resort to open surgery, which involves opening the abdomen.
LithotripsyRegarding the prevention of kidney stones, it is recommended to pay attention to hydration, particularly in the summer period and in the presence of physical activity.
Also pay attention to your diet, as the composition of your urine is directly related to your diet . The food plan must be personalized and planned together with a specialist and adapted to the type of stones to which the patient is subject. In fact, there are many aspects to take into consideration and include the consumption of proteins , vegetables , dairy products , alcohol , salt and urinary pH .