Treatment and Prevention of Urolithiasis in patients with stones of various locations

Abstract

The study goal was to find the most optimal approach to the treatment of patients with urolithiasis. The study involved 4014 patients with stones of different localization. Patients with benign prostatic hyperplas-ia (BPH) were investigated with IPSS, PSA, and uroflowmetry. 3175 ureteropyeloscopies were performed. Separately, we studied the results of treatment of 427 patients with ureterolithiasis in combination with BPH, which underwent ureterolithotripsy. Percutaneous nephrolithotrip-sy was performed in 412 patients, most of the procedures were per-formed according to the classical technique. The other research purpose was prophylaxis optimization of the recurrent urolithiasis. 152 patients participated in the experimental part. Some of the patients were taken from the clinical part of the study. All patients were with recurrent calci-um oxalate urolithiasis. Patients were divided into two groups: the 1st group (74 patients) did not receive treatment during the follow-up peri-od, the second group (42 patients) received treatment in the volume of thiazide diuretics, water load, citrate mixtures, calcium preparations in-side. During the entire follow-up (6 months), all patients underwent a comprehensive urological examination. Eventually have been estimated that surgery should not be the final stage of treatment of the urolithiasis. Urolithiasis requires constant monitoring of patients, and the priority task of a urologist is to prevent recurrent stone formation. This is achieved through the appointment of adequate conservative therapy, which includes thiazide diuretics, citrate mixtures, calcium preparations, water intake in adequate amount, and if necessary, magnesium prepara-tions. The final choice of conservative treatment depends on the type of stone. The change in the concentration of crystallization inhibitors (biku-nin and osteopontin) is a predictor of an early relapse of the urolithiasis, which can be used in monitoring patients in the postoperative period.