TACTICS IN THE DIAGNOSIS AND TREATMENT OF PATIENTS WITH COMBINED NEUROGENIC PATHOLOGY OF THE LOWER URINARY TRACT AND DISTAL COLON
DOI:
https://doi.org/10.11603/1811-2471.2017.v0.i4.8348Keywords:
neurogenic disorders in urination, intestine neurogenic dysfunction, uroflowmetry, electromyography, electrostimulation.Abstract
Introduction. Neurogenic urination disorders combine a large group of urination disorders that occur when the brain and spinal cord are damaged, leading pathways and centers of the bladder. This indicates the urgency of the problem and the need to develop diagnostic methods and their simultaneous treatment.
The purpose of the study is to increase the effectiveness of treatment for women with a combined neurogenic pathology of the lower urinary tract and distal colon.
Materials and Methods. All patients with a combined neurogenic pathology of the lower sections of the urinary system and the lower sections of the colon had a comprehensive examination using both conventional and special diagnostic methods.
We used electromyography (EMG) of the bladder and sphincter apparatus, anal sphincter, pelvic floor muscles to study the functional state of the muscles that provide the dynamic activity of the lower urinary tract and distal colonies. To strengthen the bioelectric activity of the muscles of the lower sections of the urinary system and distal colonies, an 4-channel electromyograph, "Medikor" (Hungary), was used. The EMG data were evaluated for the mean values of total bioelectric activity.
Results and Discussion. The article presents the results of treatment of patients with combined neurogenic pathology of the lower urinary tract and the distal part of the large intestine. Efficacy was assessed using clinical and urodynamic surveys. It has been established that the electromyography of uroflowmetry reflects the functional state of the urinary tract and distal parts of the colon at their combined pathology. The obtained results were the basis for substantiating the principles of differentiated treatment of patients with combined neurogenic pathology of the lower urinary tract and distal colon, which allowed to increase the effectiveness of treatment. Conservative treatment of patients of this category by means of electrostimulation is effective.
Conclusions. 1. Data of electromyographic and urodynamic studies allowed to develop and optimize treatment methods depending on the state of tone of the neuromuscular structures of the lower urinary tract and distal colon. 2. The complex differential approach to conservative treatment is aimed at correction of the disorders of the functional state of the lower urinary tract and of the distal colon units revealed during the electrophysiological and urodynamic examination.
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