PATHOPHYSIOLOGICAL AND NEUROPHARMACOLOGICAL FEATURES OF THERAPY OF CHRONIC RETENTION OF URINE IN MULTIPLE SCLEROSIS

Chronic neurogenic retention of urine (CNRU) is a very common and characteristic complication of demyelinating disease of the central nervous system - multiple sclerosis (MS). Comparison of clinical, urodynamic and neuroimaging features of CNRU in MS patients allowed to determine the spinal and cerebral components of the «sphincter» and «detrusor» urinary retention, as well as sensory and motor components. Using the method of comparing clinical, neuroimaging and urodynamic data made it possible to describe the pathogenesis of the development of urinary tract disorders in MS, and the use of method of neuropharmacologic analysis allowed to substantiate the symptomatic therapy of the various forms of CNRU occurring in this disease. The double mechanism of action (central and peripheral) of α1-adrenoblocker for its application in patients with detrusor-sphincter dissynergy (DSD) is described for the first time. The use of mono- and multicomponent symptomatic therapy based on compensation of disturbed reflex connections between the brain and spinal urination centers with the use of α1-adrenoblocker, anticholinesterase agent and GABA agonist in patients with DSD, pseudodissinergia and detrusor hypotony due to MS allowed to compensate the deficiency of impaired functions of lower urinary tract.

chronic neurogenic retention of urine, multiple sclerosis, detrusor-sphincter dyssynergia, urination centers, urinary reflexes, α1-adrenoblockers