Correction of urinary disorders in the early postoperative period after a trocar synthetic sling

Background. After synthetic sling surgery, “de novo” urination disorders often occur, which requires correction. Pollakiuria, urgency and urge urinary incontinence, in various combinations, may require symptomatic therapy for a period of 1–2 months.

Objective. Evaluation of the effectiveness of correction of urinary disorders after trocar synthetic sling (TSS) surgery in the early postoperative period against the background of combination therapy with M-anticholinergic and alpha1-blocker.

Methods. We followed-up 140 women (mean age 55.5 years) who underwent surgical interventions using the Danilov-Volnykh method due to existing stress urinary incontinence. The urodynamic situation was monitored using a non-invasive method of in-home 2–3-day uroflowmetric monitoring. Correction of urinary disorders was carried out by prescribing combination therapy with an M-anticholinergic (Spasmex, Trospium chloride) at a dosage of 15 mg 2 times a day and the alpha1-adrenergic blocker Doxazosin, at a dosage of 1–4 mg with titration. The duration of therapy was 12 weeks.

Results. It was found that both minimum capacities and average volumes increased during therapy. Combination therapy with administration of an alpha1-blocker in this regard looks more attractive, since it will neutralize the decrease in detrusor contractility and, according to the neurophysiological model, improve the clinical picture of urinary disorders. Combination therapy prescribed for a period of up to 3 months had a positive effect.

Conclusion. The occurrence of “de novo” urinary disorders in the early postoperative period is successfully verified using uroflowmetric monitoring, and combination therapy with M-anticholinergic (Spasmex) and alpha1-blocker can successfully and quickly eliminate the resulting urinary disorders.