Применение объемообразующих препаратов для коррекции стрессового недержания мочи у женщин

Abstract

The problem of stress urinary incontinence (SUI) has become particularly important in recent years. Increasing life expectancy and the desire to improve the quality of life have led to a greater emphasis on these complaints and early referral to specialist care. There are various treatment options for SUI in women that aim to prevent involuntary urination when intra-abdominal pressure increases during physical activity, coughing or sneezing. Among these options, bulking agents occupy a certain niche. Objective. To study the efficacy of bulking agent injections depending on the angle of urethral mobility and to analyze the longterm results of treatment. Patients and methods. This prospective study included 35 women with SUI who experienced failure of behavioral therapy. Patients were divided into two groups depending on urethral mobility: group 1 (n = 15) included patients with a Q-tip angle <30°, group 2 (n = 20) – patients with a Q-tip angle ≥30°. The injection of bulking agent was performed in all patients, and a viscoelastic hyaluronic acid-based filler for contour plasty was used for peri-urethral injections. Treatment results were assessed after 3, 6, 12 and 24 months. Results. The most pronounced positive dynamics was observed in group 1 (with a lower Q-tip angle). Significant improvement at 3 months after injection was noted in 66.7% of patients (n = 10). In group 2 with urethral hypermobility, improvement was noted only in 45% of women (n = 9), which is 21.7% less. After 12 months, the effect in group 1 (with a Q-tip angle <30°) was 26.9% higher than in group 2, and after 24 months it was 20% higher. Conclusion. Peri-urethral injections of bulking agents are most effective at a lower angle of urethral mobility. Further research in this area is needed. Key words: stress urinary incontinence, bulking agents