Surgical correction of overactive bladder resistant to standard therapy
- Autores: Zuban' ON1, Lebedev AA1, Zuban ON1, Lebedev AA1
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Afiliações:
- Edição: Nº 4 (2010)
- Páginas: 11-15
- Seção: Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/277751
- ID: 277751
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Resumo
Surgical treatment was given to 45 patients with overactive bladder: transurethral detrusorotomy was made in 21 patients (group 1), bladder hydrodilation (BH) was made in 24 patients (group 2). Detrusorotomy was performed by transurethral median cut of the bladder posterior wall by needle electrode leading to destroyment of intramural sympathic and parasympathic nervous fibres. Hydrodilation of the bladder was made under intravesical pressure equal to systolic arterial pressure with 2 min exposure. On day thirty after the operation regress of the lower urinary tract symptoms was registered in 20 (95.2%) patients of group 1 and 11 (45.8%) patients of group 2. Urge to voiding (UV) disappeared in 90.5% patients of group 1 and in 45.8% of group 2 (p < 0.05), the number of patients with miction pain reduced 6-fold and 1.9-fold, with UV - 8.5 and 1.2-fold, respectively (p < 0.05). The number of diurnal mictions in group 1 decreased 3.2-fold vs 1.9-fold in group 2. The bladder size in urgency in group 1 patients increased 2.5-fold, the pressure fell also 2.5-fold. In group 2 these parameters changed only 1.2 times (p < 0.05). Cystometry recorded recurrent detrusor overactivity in 13 (54.2%) patients after hydrodilation and only in 3 (14.3%) - after cut of the bladder wall (p < 0.05). Thus, transurethral detrusorotomy in overactive bladder resistant to conventional treatment is much more effective than hydrodilation. The operation is low invasive and is well tolerated. Simple performance and good short-time results are advantages of this technique.
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Bibliografia
- Abrams P., Cardozo L., Fall M. et al. The standartzation of terminology of lower urinary tract function: report from the Standartization Sub-committee of the International Continence Society. Am. J. Obstetr. Gynecol. 2002; 187: 116-126.
- Пушкарь Д. Ю. Гиперактивный мочевой пузырь у женщин. М.: МЕДпресс-информ; 2003.
- Milsom I., Abrams P., Cardozo L. et al. How widespread the symptoms of an overactive bladder and how are they managed? A population based prevalence study. Br. J. Urol. Int. 2001; 87: 760-766.
- Stewart W. F., Van Rooyen J. B., Cundiff G. W. et al. Prevalence and burden of overactive bladder in the United States. Wld J. Urol. 2003; 20: 327-336.
- Reeves P., Irwin D., Kelleher C. et al. The current and future burden and cost of overactive bladder in five European countries. Eur. Urol. 2006; 50: 1050-1057.
- Global Market Research Study, December 2003 Astellas. Data on file.
- Mundy A. R. Surgical treatment of detrusor instability. Neurourol. and Urodynam. 1985; 4: 357.
- Parsons K. F., Macher D. G., Woolfender I. C. A. et al. Endoscopic bladder transaction. Br. J. Urol. 1984; 56: 625.
- Lucas M. G., Tomas D. G. Endoscopic bladder transection for detrusor instability. Br. J. Urol. - 1987; 59; 526.
- Хейнманн Ф. Б. Иннервация мочевыводящих органов. Минск: Наука и техника; 1973.
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