HEALTH OF WOMAN. 2017.7(123):66–69; doi 10.15574/HW.2017.123.66
Chabanov P. V.
SI «Institute of urology of NAMS of Ukraine», Kyiv

The article presents the results of treatment of patients with hyperactive bladder with hypokinetic detrusor tone and combined neurogenic pathology of the distal colon.
The objective: to increase the effectiveness of treatment of patients with hyperactive bladder, hyperkinetic tonus of detrusor (muscle – urine ejector) and combined neurogenic pathology of the distal colon.
Patients and methods. Complex diagnostics and conservative treatment was conducted in patients with hyperactive bladder, hypotonic tonus of detrusor and combined pathology of the distal colon (36 (53%) women and 32 (47%) men). The average age of women was 43.4 ±2.1 years, men – 39.8±1.9 years. The average duration of the disease in women was 19.7±1.5 months and 22.4±1.8 months for men.
Results. After the completion of six courses of treatment, the improvement in the condition of patients was noted in the group of men. It was noted that polukiasis decreased to 7.9±1.1 times a day (68.4%, p<0.001), nocturia to 1.5±0.1 times (80%, p<0.02), mandatory desires – up to 2.3±0.1 times a day (87%, р <0.02), urinary incontinence – up to 1.1±0.1 times (63.6%, р<0.05).
After the completion of the six courses of treatment, the group recorded a significant improvement in both the clinical and laboratory results of electromyography (EMG) and UFS patients. It was noted that polukiuria decreased to 8.2±0.9 times a day (76.8%, p<0.02), nocturia 1.7±0.01 times (88.2%, p<0.001), the number of mandatory urges decreased to 2.4±0.1 times a day (87.5%, p <0.001), urinary incontinence – up to 1.5±0.1 times (80%, p<0.001).
The conclusion. To exclude organic diseases of the kidneys, urinary tract, digestive tract and central nervous system of man, in which the neurogenic pathology of the lower urinary tract and distal colon is diagnosed, should be comprehensively examined with the help of urological, neurological, x-ray, electromyography, urodynamic methods.
Key words: neurogenic disorders of urination, neurogenic bowel dysfunction, detrusor, uroflowmetry, electromyography.

REFERENCES

1. Moalli PA, Jones Ivy S, Meyn LA, Zyczynski HM. 2003. Risk factors associated with pelvic floor disorders in women undergoing surgical repair. Obstet Gynecol. 101(5 Pt 1):869–74.

2. Shelyigin YuA, Titov AYu, Shehter AB, Frolov SA, Mudrov AA, Tishenina RS, Biryukov OM, Dzhanaev YuA, Shahmatov DG, Guller AE. 2011. Harakter gormonalnogo i morfologicheskogo statusa u zhenschin s sindromom opuscheniya promezhnosti. Koloproktologiya 3:3–13.

3. Lukacz ES, Lawrence JM, Contreras R, Nager CW, Luber KM. 2006. Parity, mode of delivery, and pelvic floor disorders. Obstet Gynecol. 107(6):1253–60.

4. Renzi A, Izzo D, Di Sarno G, De Iuri A, Bucci L, Izzo G, Di Martino N. 2006. Cinedefecographic findings in patients with obstructed defecation sindrome. A study in 420 cases. Minerva Chir. 61(6):493–9.

5. Soares FA, Regadas FS, Murad-Regadas SM, Rodrigues LV, Silva FR, Escalante RD, Bezerra RF. 2009. Role of age, bowel function and parity on anorectocele pathogenesis according to cinedefecography and anal manometry evaluation. Colorectal Dis. 11(9):947–50. https://doi.org/10.1111/j.1463-1318.2008.01761.x; PMid:19207704

6. Nygaard I, Shaw J, Egger MJ. 2012. Exploring the association between lifetime physical activity and pelvic floor disorders: study and design challenges. Contemp Clin Trials. 33(4):819–27. https://doi.org/10.1016/j.cct.2012.04.001; PMid:22521947 PMCid:PMC3361559

7. Pemberton JH, Swash M, Henry MM. 2002. The Pelvic Floor: Its function and disorders. Harcourt Publisher Limited and Mayo Foundation for Medical Education and Research: 265–285.

8. Roig JV, Buch E, Alos R, Solana A, Fernandez C, Villoslada C, Garcia-Armengol J, Hinojosa J. 1998. Anorectal function in patients with complete rectal prolapse. Differences between continent and incontinent individuals. Rev Esp Enferm Dig. 90(11):794–805.

9. Blandon RE, Bharucha AE, Melton LJ, 3rd, Schleck CD, Zinsmeister AR, Gebhart JB. 2009. Risk factors for pelvic floor repair after hysterectomy. Obstet Gynecol. 113(3):601–8.