Physiotherapy technologies in rehabilitation programs in patients with urolithiasis before and after percutaneous nephroscopy

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Urinary stone disease (urolithiasis) is one of the most common urological diseases, the prevalence of which is growing every year, despite the development of new approaches to treatment. In recent decades, various endoscopic methods of treating urolithiasis, in particular, percutaneous nephroscopy, have become the most popular, however, even with such minimally invasive and non-invasive methods, the percentage of complications ranges from 5% to 11%. Despite the fairly widespread use of various physical factors in the urolithiasis treatment, it is still not possible to reduce the incidence rate. All this dictates an urgent need to search for new, more effective and safer, mainly non-drug technologies for the treatment of urolithiasis and prevention of the disease recurrence and postoperative complications. The aim of the study was to assess the effectiveness of the combined use of intravascular laser blood irradiation, ozone therapy, and light therapy (bioptron zepter) in the complex treatment of patients with urolithiasis after percutaneous lithotripsy, according to the data of ultrasound examination of the kidneys. Research materials. The study included 60 patients with urolithiasis who underwent percutaneous nephroscopy in the Urology Department of the PHI Railway Clinical Hospital “RZhD Meditsina”, Rostov-on-Don, in 2019–2020, with subsequent rehabilitation. The patients were divided into three relatively equivalent groups according to age, calculus size (from 7 to 20 mm), and stone composition. In the first (control) group, patients received standard therapy after surgery: antispasmodics, antibiotic therapy taking into account the bacterial culture of urine, non-steroidal anti-inflammatory drugs, which served as a background in the main group and the comparison group. In addition to the standard therapy, the patients in the second group (comparison group) underwent intravenous laser blood irradiation (ILBI) and ozone therapy. The patients of group 3 (main group) received intravenous laser blood irradiation (ILBI) and ozone therapy — 6 procedures each in the preoperative period against the background of standard therapy; polarized light and ILBI — 6 procedures each in the early postoperative period. Results. The article shows a higher efficacy of the combined use of ILBI, ozone therapy and light therapy in the complex treatment of patients with urolithiasis before and after percutaneous nephroscopy. Conclusion. Combined use of a course of intravenous laser blood irradiation (ILBI) and ozone therapy in the preoperative period and a course of polarized light and ILBI in the early postoperative period after percutaneous nephroscopy against the background of standard therapy in patients with urolithiasis contributes to a significant improvement in blood flow in the kidney and a reduction in the recovery period of the renal parenchyma, which made it possible to reduce the patient’s stay in the hospital, due to the prevention of the development of postoperative complications.