Оцінка якості життя у динаміці лікування у жінок зі стресовим нетриманням сечі

Abstract

The article reflects the results of a study of the quality of life in patients of perimenopausal age against the background of CO2-laser use on the eve and after complex treatment. Today in Ukraine, the number of women suffering from stress urinary incontinence is steadily growing, and the problem has moved from purely medical to the rank of medical and social. Stress urinary incontinence significantly reduces the quality of life of women, leading to discomfort, causes a woman to change her usual behavior, makes her more withdrawn, is accompanied by serious psychoemotional disorders (depression, psychological stress, depression), leads to severe physical and moral suffering, social maladaptation. That is why assessing the quality of life in women with stress urinary incontinence is considered extremely relevant. Today, conservative and surgical techniques are used to treat stress urinary incontinence. However, none of these methods contributes to the complete disappearance of symptoms of stress urinary incontinence, and the relapse rate after the disease is high, which forces a woman to long-term follow-up and treatment, significantly worsening her quality of life. The objective: to assess the quality of life before and after the use of a CO2-laser in the complex treatment of stress urinary incontinence in premenopausal patients. Materials and methods. 89 patients with stress urinary incontinence were examined. Depending on the prescribed therapy, it is divided into two groups. The main group included 44 women who were offered CO2-laser therapy in combination with local hormone therapy. The comparison group was formed by 45 women who were prescribed only topical estriol therapy. In order to assess the quality of life of women with stress urinary incontinence, a survey of patients was conducted using a specialized PFDI-20 questionnaire, and the FSFI questionnaire was used to assess the female sexuality index. The quality of life score and female sexuality index were determined before treatment and 6 and 12 months after the start of treatment. Results. According to the PFDI-20 questionnaire, 6 months after the start of treatment, there was no significant difference in the number of points in women in the study groups. After 12 months from the start of treatment, significant differences in the median scores were recorded (the main group – 18 points; the comparison group – 30 points; p<0.05). Evaluating the index of sexual function in the dynamics of treatment according to the FSFI questionnaire, a significant increase in this indicator was noted in women of the main group (median before treatment – 25 points; after 6 months from the start of treatment – 35 points; after 12 months from the start of treatment – 46 points; p<0.05). Evaluating the results of the UDI-6 questionnaire 12 months after the start of treatment, we drew attention to significant differences in the symptoms of urinary incontinence in women who received CO2-laser therapy in combination with local estriol therapy before treatment and compared to women who received only estriol locally. Conclusions. The inclusion of a CO2-laser in combination with local administration of estriol in the complex treatment of stress urinary incontinence can significantly reduce the manifestations of this complication, which is confirmed by a significant decrease in the median score from 55 to 18 in women of the main group according to the results of the PFDI-20 questionnaire (p<0.05). The index of sexual function in women who received the proposed complex based on the results of the FSFI questionnaire experienced a significant increase from 25 to 46 points (p<0.05). The results of a survey using the UDI-6 questionnaire indicate a significant reduction in the symptoms of stress urinary incontinence in women in the main group compared to women who received only local estriol therapy. Keywords: stress urinary incontinence, CO2-laser, estriol, quality of life.