CURRENT ISSUEOBSTETRICS AND GYNECOLOGY
International Medical Journal, Vol. 27., Iss. 3, 2021, P. 30−32.
ON THE ISSUE OF URINARY INCONTINENCE IN WOMEN
Municipal Non−Profit Enterprise of Kharkiv City Council "Regional Clinical Perinatal Center", Kharkiv, Ukraine
An important and very delicate medical problem, i.e. urinary incontinence in women of perimenopausal age has been considered. There are two types of this condition: anatomical and associated with bladder disease. According to the classification of the International Continence Society (2002) there are stress incontinence, imperative (urgent), mixed, enuresis (night), permanent etc. Diagnosis includes careful history taking, complete clinical examination, assessment of gynecological status, laboratory methods (general analysis and bacterial examination of urine), functional tests (cough, straining, one−hour pad test, swab−applicator), complex urodynamics, urofluorometry, profilometry of urethra), and cystoscopy according to the indications. Treatment can be conservative or operative. Conservative one involves the use of anticholinergic drugs, alpha−adrenoceptor antagonists, serotonin and norepinephrine reuptake inhibitors for 3−5 months. In the absence of drug therapy effect, it is necessary to address the issue of surgical treatment (mostly performed sling operations using synthetic materials: TVT, TVT−o). In the presence of genital prolapse, surgical correction is indicated, because 80 % of women with lowering of the internal genitals are diagnosed with stress urinary incontinence. When the uterus falls out, there are performed its extirpation, colporrhaphy, colpoperineoraphy. At the same time there the urethropexy is also done. Vaginal access is getting better due to the fact that during surgery the symptoms of urinary incontinence are eliminated. Thus, urinary incontinence is an extremely delicate problem that is at the intersection of two specialties,namely gynecology and urology, its solution requires a differentiated, individual approach to the choice of treatment tactics.
Key words: urinary incontinence, involuntary urination, perimenopausal age, urethropexy, genital prolapse.
1. Apolikhina I. A. Klinicheskaya epidemiologiya, differentsial'naya diagnostika i konservativnoe lechenie nederzhaniya mochi u zhenshchin: avtoref. dis. … d−ra med. nauk: 14.01.06. M., 2006. 47 s.
2. The standardization of terminology of lower urinary tract function: report from the standardization sub−committee of the International Continence Society / P. Abrams et al. // Neurourology and Urodynamics. 2002. Vol. 21. P. 167 178. doi: https://doi.org/10.1002/nau.10052
3. Yatsina O. І. Patogenetichnі mekhanіzmi urodinamіchnikh rozladіv ta їkh eksperimental'na farmakoterapіya (eksperimental'no−klіnіchne doslіdzhennya): avtoref. dis. … d−ra med. nauk. Sumi, 2019. 39 s.
4. Vibіr metodu khіrurgіchnogo lіkuvannya stresovogo netrimannya sechі u zhіnok bez prolapsu tazovikh organіv / V. І. Gorovii, O. І. Yatsina, L. Yu. Trifonyuk, R. K. Balats'kii // Medichnі aspekti zdorov'ya zhіnki. 2017. № 5. S. 36−45.
5. Chaika O. M. Perіoperatsіina dіagnostika ta diferentsіiovane lіkuvannya netrimannya sechі u zhіnok z genіtal'nim prolapsom (klіnіko−eksperimental'ne doslіdzhennya): avtoref. dis. ... kand. med. nauk: 14.01.06. K., 2016. 24 c.