Treatment of persistent dysuria in females

Abstract

Sixty female patients with chronic cystitis and persistent dysilria (PD) were divided into two groups according to their treatment. Group 1 (n - 38) patients have received combined conservative treatment; group 2 (n = 22) received the above treatment plus have undergone transurethral resection (TUR) of the urinary bladder mucosa. For control, urodynamic tests were made (uroflowmetry, sphincterometry, electromyography of the urinary bladder muscles); microcirculation was studied at laser doppler flowmetry. It was found that PD females with chronic cystitis develop microcirculatory disorders registered at laser doppler flowmetry. They consist in congestion of blood in the microvessels, vascular spasm, red cell aggregation with sludgesyndrome and combine with urodynamic disorders manifesting as weak detrusor contractivity and evacuation function. The above urodynamic and microcirculatory disorders are treated conservatively (antibacterial therapy, transcutaneous laser irradiation of the suprapubic region using intravesical methods). To eradicate PD in long-term inflammation in the urinary bladder and development of squamous cell metaplasia of the urothelium, TUR of the affected area and intramural nerves with partial denervation of the urinary bladder is indicated.