Email this article Optimization of diagnostics and treatment of mixed and stress urinary incontinence in women
- Authors: Rusina Y.I.1
-
Affiliations:
- D. O. Ott Research Institute of Obstetrics and Gynecology, RAMS
- Issue: Vol 63, No 3 (2014)
- Pages: 44-52
- Section: Articles
- URL: https://bakhtiniada.ru/jowd/article/view/2659
- DOI: https://doi.org/10.17816/JOWD63344-52
- ID: 2659
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Abstract
Save or occurrence «de novo» of the bladder and urethra dysfunction in surgical correction of urinary incontinence (UI) among women is impotant problem of Urogynecology. Purpose: To evaluate the role of complex diagnostics in determination of the pathogenetically based tactics with mixed and stress incontinence among women. Materials and Methods: The study included 633 patients 22-88 years old with complaints of mixed (n = 356) and stress (n = 277) UI before treatment (medical, physiotherapy, sling surgery): 119 - clinically, 514 - complexly (clinical examination and complex urodynamic testing). Surgical correction of pelvic organ prolapse is performed to 270 patients. Complex examination was repeated to all of them in 1-3 and 12-36 months after treatment. Results: detrusor overactivity - DO (32.9 %) and urethral instability (23.1 %) before surgery is more common among patients with complaints of mixed incontinence, but among patients with stress complaints this pathology is also found in 5 %, and 8.3 % of cases, respectively. 55.9 % patients with complaints of mixed incontinence and 47.2 % - with stressful complaints were not operated in connection with full or significant reduction of complaints on the background of pathogenic conservative therapy. The efficacy of sling operations for stress and mixed incontinence is high but not statistically different and generally amounts to 97.1 % in 3-36 months after surgery. The frequency of postoperative dysfunction among clinically examined patients with complaints of mixed incontinence was in general 46 %, the frequency among complexely examined patients - 9.7 %. (OR 7,7, 95 % CI 2,9-20,3). Conclusion: Complex examination with the use of urodynamic testing, the therapy of bladder and urethra neuro-muscular dysfunction, the selection of patients for surgical treatment leads to a significant reduction of dysfunction number in early and late postoperative period and improve patients’ satisfaction with the treatment.
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##article.viewOnOriginalSite##About the authors
Yelena Ivanovna Rusina
D. O. Ott Research Institute of Obstetrics and Gynecology, RAMS
Email: iagmail@ott.ru
PhD. Assistant professor of Operative Gynecology Department
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