Journal of obstetrics and women's diseasesJournal of obstetrics and women's diseases1684-04611683-9366Eco-Vector886810.17816/JOWD67240-51Research ArticleClinical efficiency of desmopressin and cyclooxygenase inhibitor use in incontinent womenOsipovaNatalya A.<p>Professor Assistant, PhD, Medical Faculty. Department of Obstetrics, Gynecology and Reproductology</p>naosipova@mail.ruNiauriDariko A.<p>MD, Prof. PhD, DMedSci, Medical Faculty, Department of Obstetrics, Gynecology and Reproductology</p>d.niauri@mail.ruGzgzyanAlexander M.<p>MD, PhD, DMedSci, Medical Faculty, Department of Obstetrics, Gynecology and Reproductology, Head of Reproductive Technologies Department</p>iagmail@ott.ruResearch Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott15062018672405123052018Copyright © 2018, Osipova N.A., Niauri D.A., Gzgzyan A.M.2018<p><strong>Hypothesis/aims of study</strong>. Questions regarding the pathogenesis of urine incontinence and methods of treatment are acti vely discussed by gynecologists, urologists, and neuropathologists. Urine incontinence often has multifactor origins: the causes of urine incontinence are connected, as a rule, with the violation of urine continence functional mechanisms, anatomotopographical features of the lower urinary tract, or an premature ovarian failure. Simultaneously, changes in kidney function play a role in the pathogenesis of urine incontinence. In some cases, urine incontinence is combined with urine overproduction or inversion of the circadian rhythm of renal function owing to a decrease in the reabsorption of sodium ions in the thick ascending limb of the loop of Henle. In some patients, we successfully normalized ion transport, diuresis, and circadian rhythm of urine production by desmopressin or diclofenac administration. The present analysis was undertaken to evaluate the clinical efficiency of desmopressin and diclofenac in incontinent patients with nocturnal polyuria and polyuria.</p>
<p><strong>Study design, materials, and methods</strong>. In total, 130 patients with complaints of urinary incontinence, polyuria (24-h urine volume of 40 mL/kg bodyweight or above), or nocturnal polyuria (nocturnal volume/24-h urine volume of 0.33 or above); 30 incontinent women without polyuria or nocturnal polyuria (comparison group); and 14 control subjects were included. The mean patient age was 43.6 4.5 years (41.8 3.7 years in the comparison group and 39.4 6.3 years in the control group, p 0.05). All the participants performed seven days of urine collection to determine the voided volumes. Patients with polyuria or nocturnal polyuria performed the 3-fold 24-h pad-test. Patients with polyuria and nocturnal polyuria were examined twice: in the initial state and one month after the start of treatment with the optimal dose of diclofenac or desmopressin (Minirin).</p>
<p><strong>Results</strong>. The use of both diclofenac or desmopressin in patients with various types of urine incontinence, polyuria, or nocturia decreased the volume of voided urine because of the normalization of diuresis and an increase in cystometric bladder capacity.</p>urine incontinencepolyurianocturiasodium diclofenacdesmopressinнедержание мочиполиурияниктуриядиклофенак натрия, десмопрессин[Аполихина И.А., Ромих В.В., Андикян В.М. Современные принципы консервативного лечения недержания мочи у женщин // Урология. — 2005. — № 5. — С. 72–75. [Apolikhina IA, Romikh VV, Andikyan VM. Current principles of conservative treatment of urine incontinence in women. Urologiia. 2005;(5):72-75. (In Russ.)]][Балан В.Е., Анкирская А.С., Есесидзе З.Т., Муравьева В.В. Патогенез атрофического цистоуретрита и различные виды недержания мочи у женщин в климактерии // Consilium medicum. — 2001. — Т. 3. — № 7. — С. 326–331. [Balan VE, Ankirskaya AS, Esesidze ZT, Murav’eva VV. 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