PELVIC PAIN-COMPLICATED CHRONIC TRIGONITIS IN EARLY-STAGE PROLAPSE IN WOMEN: PRINCIPLES OF MEDICAL TREATMENT


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Resumo

Objective. To evaluate the efficiency of drug treatment with the Russian oral antibiotic safocid for grades 1 and 2 pelvic prolapse complicated by chronic trigonitis and pelvic pain syndrome. Subjects and methods. Fifty patients with grades 1 and 2 pelvic prolapse complicated by chronic trigonitis and pelvic pain syndrome, which had been caused by a congestive inflammatory process in the bladder, parametrium, and descent vaginal walls, were examined. The study comprised medical history data collection, gynecological examination, transvaginal ultrasonography, combined urodynamic examination (CUDE), and cystoscopy. Results. All the patients had varying clinical manifestations. According to uroflowmetric evidence, there was a preponderance of obstructive urination. Cystomanometry showed the signs of the overactive bladder. Combination therapy included the use of safocid by the scheme: a single dose of 4 tablets 1 hour before or 2 hours after a meal on days 1, 7, and 14 of treatment; intravesical instillations of different uroseptics, vitamins B 1, B 6, and B 12, and nonsteroidal anti-inflammatory drugs. The findings suggest that safocid is highly effective in the combination drug treatment of dysuria, pelvic pain, and urge incontinence in the early stages of genital prolapse. After the treatment performed, all the patients reported pain and discomfort disappearance during voiding, the cystoscopic pattern became normal, and the signs of obstructive urination and overactivity diminished, as shown by CUDE. Dyspareunia and episodes of urinary incontinence disappeared in 13 and 47 patients, respectively. Conclusion. Thus, combination treatment with the broad-spectrum combined drug safocid in patients with early-stage prolapse complicated by chronic trigonitis makes it possible not only to eliminate an inflammatory process in the trigone region of the bladder, but also to reduce or stop urinary incontinence episodes and chronic pelvic pain syndrome.

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Sobre autores

A. NEIMARK

Altai State Medical University

Email: shelln@rambler.ru

N. SHELKOVNIKOVA

OAO «RZhD»

M. RAZDORSKAYA

Station District Clinical Hospital, Barnaul

Bibliografia

  1. Гинекология: Национальное руководство // Под ред. B.И. Кулакова и др. - М.: ГЭОТАР-Медиа, 2009. - C. 864.
  2. Теплов С.А. Уретриты, циститы, кольпиты, вулвовагиниты. - М.: КРОН-ПРЕСС, - 2000. - С. 177.
  3. Capple C.R. et al. Multidisciplinary management of female pelvic floor disordes. - Amsterdam: Elserver, 2006.
  4. Petros P.E. The female pelvic floor. Function, dysfunction and management according to the integral theory. - Berlin et al.: Springer, 2004.

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