UrologiiaUrologiiaУрология1728-29852414-9020Bionika Media286692ArticlesСтатьиResearch ArticleRecurrent urinary incontinence in women: causes and treatmentsРецидивное недержание мочи у женщин: причины и методы леченияKasyanG. RКасянГ. Р

Dr.Med.Sci., Prof. at the Department of Urology

д.м.н., профессор кафедры урологии

g.kasyan@outlook.comStroganovR. VСтрогановР. В

Department of Urology

врач-уролог

Pushkar'D. YuПушкарьД. Ю

Department of Urology

д.м.н., профессор, главный уролог МЗ РФ, зав. кафедрой урологии

pushkardm@mail.ruA.I. Evdokimov Moscow State University of Medicine and DentistryМГМСУ им. А.И. ЕвдокимоваA.I. Evdokimov Moscow State University of Medicine and DentistryГБОУ ВПО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова»191220162SSupplementПриложение768126022023Copyright ©; 2016, Bionika MediaCopyright ©; 2016, ООО «Бионика Медиа»2016Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/1728-2985/article/view/286692

Quite often patients assume that any new onset of urge incontinence or nocturia is recurrent urinary incontinence. Is it possible to consider any similar situation as the recurrence of urinary incontinence? No, of course not. However, if you put at the forefront a patient satisfaction with the overall result of the surgery, rather than a formal negative cough test, the picture will be somewhat different. On the one hand, it brings us back to criteria of surgery success, and on the other to the indications for repeat surgery. All this highlights the importance of thorough examination of patients with urinary incontinence. Patient evaluation begins with taking a complete medical history, reviewing chief complaints and filling in urination diary. If a re-operation is indicated, the following surgical options should be considered: sling operations, colposuspension or tapes using patient own tissue. The choice of surgical treatment for recurrent urinary incontinence should be based on the results of a thorough evaluation of the individual patient, including urodynamic parameters and supplementary imaging studies. The most important factors influencing the choice of method of re-surgery were the type of the previous operation, the results of urodynamic studies, and the preference and experience of the surgeon.

Весьма часто рецидивом недержания мочи больными считается вновь возникшее ургентное недержание мочи или ноктурия. Можно ли рассматривать любую подобную ситуацию как рецидив недержания мочи ? Разумеется, нет. Однако если во главу угла поставить общую удовлетворенность пациентки результатом операции, а не формальную отрицательную кашлевую пробу, то картина получится несколько иной. С одной стороны, это возвращает нас к разговору о критериях успешности операции, с другой - к показаниям к выполнению повторного оперативного лечения. В связи с этим представляется важным тщательное обследование пациенток с недержанием мочи. Обследование пациенток начинается с выяснения их жалоб, данных анамнеза и заполнения дневника мочеиспускания. При наличии показаний к повторному оперативному лечению следует учитывать следующие моменты: в качестве основных методов лечения рецидива недержания мочи можно рассматривать слинговые операции, кольпосуспензию или петлевую пластику с использованием собственных тканей. Выбор оперативного лечения по поводу рецидива недержания мочи должен быть основан на результатах тщательной оценки индивидуальных особенностей пациентки, включая уродинамические показатели и данные дополнительных средств визуализации. Наиболее важными факторами, влияющими на выбор метода повторного оперативного лечения, явились тип предыдущей операции, результаты уродинамического исследования, а также предпочтение и опыт хирурга.

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