Approaches to the Treatment of Patients with Upper Urinary Tract Stones and Comorbid Vascular and Cardiological Pathology

Abstract

Urinary stone disease (USD) is associated with the formation of sand and calculi in the organs of the urinary system. This is a common chronic pathology, which is characterized by the frequent exacerbations and a severe course. Without timely treatment, USD threatens of the urinary tract blockage and intoxication of the organism. The article emphasizes the importance of carefully the treatment choose of patients with stones of the upper urinary tract and vascular and cardiac pathologies, because these nosologies have common etiological links and are related to age and sex. An analysis of methodological and scientific literature was carried out to study approaches to the treatment of patients with USD with comorbid vascular and cardiac pathologies. Various methods were used, namely: the search for methodological and scientific literature, in particular induction and deduction, comparison, classification, systematization, abstraction and specification, analysis of documentation. The analysis of approaches to the treatment of patients with stones of the upper urinary tract demonstrated that there are two main approaches to treatment – conservative therapy and surgical treatment. Due to a number of reasons, conservative medical treatment can be used only in some cases as the method of choice for the treatment of patients with USD. The use of extracorporeal shock wave lithotripsy (ESWL) for the destruction of stones in the kidneys and ureters significantly increases the effectiveness of treatment of the patients. However, in patients who were operated for cardiovascular pathology, in the case of complete withdrawal of anticoagulant therapy, even for a short period, the risk of complications increases. Therefore, before performing ESWL in such patients, it is recommended to reduce the anticoagulant dose or switch to low-molecular-weight heparins 3-4 days before the planned surgical intervention. During the treatment of patients with calculi of the upper urinary tract and vascular and cardiac pathologies, a careful choice of treatment and the involvement of related specialists are necessary.