Лікування хворих з гіперактивним сечовим міхуром, гіпокінетичним тонусом детрузора та поєднаною нейрогенною патологією дистального відділу товстої кишки

Abstract

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.