DYNAMICS OF CHANGES IN ELECTROMYOGRAPHY INDICATORS OF THE LOWER URINARY TRACT DEPENDING ON THE DEGREE OF DISTURBANCE IN THE METABOLISM OF MINERAL STONE-FORMING SALTS IN PATIENTS WITH NEUROGENIC URINATION DISORDERS
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i4.15031Keywords:
crystalluria, electromyographyAbstract
SUMMARY. The aim – to establish the dependence of the functional state of the lower urinary tract of patients with hypercrystalluria on the degree of mineral salt metabolism disorder.
Material and Methods. 69 patients were under observation, of which 37 were men and 32 were women. All patients underwent a comprehensive examination using both generally accepted and special diagnostic methods, among which electromyography took the main place. An electromyograph "Medicor M440" was used to record electromyography. To remove the biopotentials of the detrusor and its sphincter apparatus, we used special electrodes – catheters. The analysis of the results of electromyography was carried out according to the indicators of the average voltage value.
All patients underwent general urinalysis and salt transport. Depending on the type of hypercrystalluria and the functional state of the lower urinary tract, complex conservative treatment was carried out. The results were evaluated after 3 months, 6 months, 12 months.
Results. When analyzing the indicators of the average value of the difference in detrusor biopotentials, a gradual decrease of 12.5 % was obtained in the course of treatment in men, and a decrease of 13.1 % in women.
During the control examination of patients, in the vast majority of cases (85.5 %), a positive effect and correlation of clinical and electromyographic indicators were noted. In 14.5 % of cases, patients who subjectively did not note a positive effect of the treatment, also did not notice positive dynamics during EMG.
Conclusions. 1. An electromyographic examination with a neurogenic bladder and crystalluria revealed increased tone of the neuromuscular structures of the lower urinary tract.
- Reducing the degree of impaired metabolism of mineral stone-forming salts led to the correction of electromyographic indicators of the lower urinary tract in patients with crystalluria and neurogenic urination disorders.
- The obtained electromyography data will allow to develop and optimize methods of treatment of neurogenic bladder and crystalluria depending on the state of tone of the neuromuscular structures of the lower urinary structures.
References
Skolarikos, A., Neisius, A., Petřík, A., Somani, B., Thomas, K., Gambaro, G., ... & Tzelves, L. (2022). Urolithiasis. In EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam.
Borg, R., Carlson, N., Søndergaard, J., & Persson, F. (2023). The growing challenge of chronic kidney disease: an overview of current knowledge. International Journal of Nephrology, 2023(1), 9609266. DOI: https://doi.org/10.1155/2023/9609266
Qian, X., Wan, J., Xu, J., Liu, C., Zhong, M., Zhang, J., ... & Wang, S. (2022). Epidemiological Trends of Urolithiasis at the Global, Regional, and National Levels: A Population-Based Study. International Journal of Clinical Practice, 2022(1), 6807203. DOI: https://doi.org/10.1155/2022/6807203
Anders, H.J., Li, Q., & Steiger, S. (2023). Asymptomatic hyperuricaemia in chronic kidney disease: mechanisms and clinical implications. Clinical kidney journal, 16(6), 928-938. DOI: https://doi.org/10.1093/ckj/sfad006
FitzGerald, J.D., Dalbeth, N., Mikuls, T., Brignardello-Petersen, R., Guyatt, G., Abeles, A.M., ... & Neogi, T. (2020). 2020 American College of Rheumatology guideline for the management of gout. Arthritis & Rheumatology, 72(6), 879-895. DOI: https://doi.org/10.1002/art.41247
Sautner, J., Eichbauer-Sturm, G., Gruber, J., Lunzer, R., & Puchner, R. J. (2022). 2022 update of the Austrian Society of Rheumatology and Rehabilitation nutrition and lifestyle recommendations for patients with gout and hyperuricemia. Wiener klinische Wochenschrift, 134(13), 546-554. DOI: https://doi.org/10.1007/s00508-022-02054-7
Finazzi-Agrò, E., Giraudo, D., Pletto, S., & Lamberti, G. (2023). Physiotherapy for Urinary Incontinence. In Textbook of Female Urology and Urogynecology (pp. 420-432). CRC Press. DOI: https://doi.org/10.1201/9781003144236-47
Smith, A., Bevan, D., Douglas, H. R., & James, D. (2013). Management of urinary incontinence in women: summary of updated NICE guidance. BMJ, 347. DOI: https://doi.org/10.1136/bmj.f5170
Thüroff, J.W., Abrams, P., Andersson, K.E., Artibani, W., Chapple, C.R., Drake, M.J., ... & Tubaro, A. (2011). EAU guidelines on urinary incontinence. Actas Urológicas Españolas (English Edition), 35(7), 373-388. DOI: https://doi.org/10.1016/j.acuroe.2011.03.002