THE ROLE OF TESTING THE FUNCTIONS OF THE SPINAL CENTERS OF URINATION AND DEFECATION IN THE CHOICE OF TREATING METHODS FOR PATIENTS WITH A COMBINED NEUROGENIC PATHOLOGY OF THE LOWER URINARY TRACT AND DISTAL COLON, DEPENDING ON THE TONE OF THE NEUROMUSCULAR STRUCTURES
DOI:
https://doi.org/10.11603/2415-8798.2017.4.8210Keywords:
neurogenic bladder disorders, neurogenic bowel dysfunction, detrusor, electromyography, bulbocavernous reflex.Abstract
The article presents the role of testing the functions of the spinal centers of urination and defecation in the choice of treatment methods for patients with a combined neurogenic pathology of the lower urinary tract and distal colonies, depending on the tone of the neuromuscular structures.
The aim of the study – to increase the effectiveness of treatment of patients with combined neurogenic pathology of the lower urinary tract and distal colon.
Materials and Methods. To achieve the goal, 127 patients with combined neurogenic pathology of the lower urinary tract and distal colon were examined. Men and women were divided into two main groups, depending on the state of the tone of the detrusor and the distal colon. An electromyograph "Medikor M-440" was used for the recording of electromyography (EMG ) with the study of bulbocavernous reflex (BCR). With this device, 19 healthy men and 18 women who were in the control group were pre-screened. The need to create this group resulted from the need to study the normal functional parameters of the bulbous coronary muscle (BCM). Using the electromyograph "Medikor M-440", the following methods of research were conducted: the determination of the potential of BCM alone in order to exclude changes in the muscle under study, then directly determined BCM, and then measured the latent period (LP ) of BCM.
Results and Discussion. In the examination of men in the first group, the average indicator of polycurial treatment was (5.2±1.1), nocturia (4.1±0.9) times a day, imperative calls were (2.1±0.4) times a day, and imperative urinary incontinence was marked (1.9±0.3) times a day. PPB C questionnaire rating was (4.4±0.5) points. In assessing the symptoms of clinical manifestations of the pathology of distal colon in men, we observed the following, namely the constipation was noted in patients (4.5±0.2) times, incontinence of gases – (4.6±0.2) times, incontinence of liquid stool in patients (2.7±0.1) times, incontinence of hard feces in men (1.6±0.1) times. When evaluating the questionnaire CRAD I-8, we received in this group of patients before treatment (18.8±0.2) points. During carrying out of a bulbocavernous reflex evaluation, its latent period in patients in this group was (41.8±1.7) m / sec. The obtained data allowed to develop and optimize treatment methods depending on the state of tone of the neuromuscular structures of the lower urinary tract and distal colonies.
Conclusions. Thus, in patients of the second group, the increase in the tone of the neuromuscular structures in the hyperreflex type with small volumes of urine and feces may be the pathogenetic mechanism of neurogenic disorders of the NSA of the pathways and of the distal parts of the colon. The obtained results were the basis for substantiation of the principles of differential treatment of patients with a combined neurogenic pathology of the lower urinary tract and distal colon.
References
Gormley, E.A., Lightner, D.J., Faraday, M., & Vasavada, S.P. (2015). Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. The Journal of Urology, 193 (5), 1572-80.
Nurko, S. & Scott, S.M. (2011). Coexistence of constipation and incontinence in children and adults. Best Practice & Research Clinical Gastroenterology, (25), 1, 29-41.
Walden, A.L., Salsbury, S.A., Reed, W.R. & Lawrence, D.J. (2014). Bladder and Bowel Symptoms Among Adults Presenting With Low Back Pain to an AcademicChiropractic Clinic: Results of a Preliminary Study. Journal of Chiropractic Medicine, (13), 3, 178-187.
Lukacz, E.S., Lawrence, J.M., Contreras, R., Nager, C.W. & Luber, K.M. (2006). Parity, mode of delivery, and pelvic floor disorders. Obstet Gynecol, 107, (6), 1253-1260.
Samaranayake, C.B., Luo, C., Plank, A.W., Merrie, A.E., Plank, L.D. & Bissett I.P. (2010). «Systematic review on ventral rectopexy for rectal prolapse and intussusception». Colorectal disease : The official journal of the Association of Coloproctology of Great Britain and Ireland, 12, (6), 504-512.
Nygaard, I., Shaw, J. & Egger, M.J. (2012). Exploring the association between lifetime physical activity and pelvic floor disorders: study and design challenges. Contemp Clin Trials, 33, (4), 819-827.
Blandon, R.E., Bharucha, A.E., Melton, L.J., (3rd), Schleck, C.D., Zinsmeister A.R. & Gebhart, J.B. (2009). Risk factors for pelvic floor repair after hysterectomy. Obstet Gynecol, 113, (3), 601-608.
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