No 4 (2012)

Epilepsy is an important clinical interdisciplinary problem. It is known that about half of epileptic patients are women, and over 40% of them are women of reproductive age. The problem of reproductive health of women with epilepsy involves individual choice of contraceptive method that is acceptable for a given patient, depending on receiving antiepileptic therapy. Currently, the questions of choice of contraceptive methods for epileptic women using various antiepileptic drugs are poorly understood, and planning for pregnancy requires joint counseling and management by neurologist and obstetrician-gynecologist.

The article presents a comprehensive overview of the current literature on urinary incontinence in men. Data for various forms of urinary incontinence, including those arising after the surgery for prostate diseases, as well as information concerning diagnosis and treatment are evaluated and presented. Features of the nervous regulation of urination and the role of denervation processes in pelvic organs in the formation of urinary incontinence are described in detail. The article also presents own authors clinical material (n = 14) for features of diagnostics of neurogenic component of incontinence. Normative reference for the electromyographic activity of pelvic floor muscles and the corticospinal tract conductivity is developed in the group of healthy volunteers (n = 14). Significant denervation-reinnervation changes in pelvic floor, characterized by elongation of central motor conduction time, presence of positive sharp waves and fibrillation potentials, and polyphasy of action potentials of muscle units, are revealed in all patients. The identified changes are taken into account in the choice of treatment strategy; drugs that enhance trophic nutrition and conductivity of nerve tissue, as well as extracorporeal magnetic stimulation of the muscles of the perineum were used.

The prevalence of anemia among pregnant and nonpregnant women is significantly higher than among men. In routine practice, therefore, physicians often have to deal with the diagnosis and treatment of anemia in women. This literature review considers the most frequent clinical situations in daily practice of clinician detecting anemia in women: anemia in pre-and postmenopausal women, often associated with overweight and obesity, anemia of chronic disease, anemia due to intense metrorrhagia and anemia in pregnant women

The article considers the modern view on endometriosis (EM), pathogenesis, clinical presentation and complications of the disease, in particular the adhesive process in the pelvis with involvement of the fallopian tubes caused by hyperplasia of connective tissue. The data for evaluation of clinical efficacy of drug Longidaza compared with the drug Lydase in 50 women aged 21-40 years with various forms of EM, complicated by adhesive process in pelvic organs and tubo-peritoneal infertility are presented. Longidaza was superior to Lydase in terms of efficacy. These results suggest that choice of Longidaza for the prevention and treatment of adhesive process in pelvic organs in patients with EM is justified.

The place of side effects of antiepileptic drugs (AEDs) on reproductive health in the classifications of drug side effects is determined, their frequency was investigated in a cohort of 155 women of reproductive age with epilepsy observed in a specialized Department of Epilepsy in the Institute of Human Brain. Patients were divided into 3 groups: Group 1 received monotherapy with AEDs, Group 2 - polytherapy with AEDs, Group 3 did not receive AEDs. Main characteristics of epilepsy were not significant different between groups, except predominance of very frequent seizures in the polytherapy group. It is established that reproductive health disorders are common side effects of AEDs in women with epilepsy. In total cohort, the frequency of side effects was 40%. Reproductive endocrine disorders were statistically more frequent in the AED groups compared with the control group. AED polytherapy of epilepsy in women increases the incidence of reproductive disorders (58.5% compared with 10% in the control group).

The article discusses the problem of urolithiasis, the causes of nephrolithiasis and treatment of urolithiasis. Particular attention is paid to litholitic citrate therapy. The results of own authors research are presented. Citrate therapy with drug Blemaren was administered in 35 patients for 4 months; there were patients with large urate renal stones, patients who had undergone percutaneous nephrolithotomy, and patients with ureteral stones against the background of the upper urinary tract drainage by catheter-stent. Complete litholysis was observed in 19 (54.3%) patients, and reduction of stone sizes - in 12 patients (34.2%) that provided the prospects for further litholysis against the background of therapy with Blemaren.