Гинекология (Feb 2018)
Urinary incontinence. Methods of treatment
Abstract
Urinary incontinence is a serious social and medical problem in Russia and throughout the world. However, even a small percentage of women who purposefully go to the doctor about having incontinence symptoms, only 2% of patients receiving the qualified urological aid. Medical therapy is used as the primary method for all patients with an overactive bladder. As the drugs of choice, the use of M-cholinolytics affecting muscarinic receptors of the bladder is recommended. The article presents data indicating the possibility of using trospium chloride in patients of different age categories. Objective - to determine the effectiveness of the use of M-cholinolytic drug (trospium chloride) in women of different age categories. Material and methods. The study included 68 patients with symptoms of a hyperactive bladder, which, depending on their age, were divided into 2 groups. All patients received trospium chloride (Spasmex®) for 6 months. Results. After 3 and 6 months of the use of trospium chloride in patients of both groups, the complaints decreased significantly. Attention is drawn to the fact that the decrease in the number of complaints during the treatment significantly decreased more in the first three months. In women of the reproductive period, the results are more significant than in postmenopausal patients, which can be explained by the presence of hypoestrogenic condition in patients of the 2nd group, which can make the pathology worse and require the appointment of etiopathogenetic treatment. Conclusion. Trospium chloride can be recommended to patients reproductive and postmenopausal periods for relief of symptoms of overactive bladder with the contraindications. In postmenopausal women, in addition to taking trospium chloride, the need to prescribe menopausal hormone therapy (systemic, local) should be considered to compensate for the deficiency of estrogen. In the presence of prolapse of the genitals and stress component of urinary incontinence, it is necessary to resolve the issue of the need for timely surgical treatment aimed at coping with stress urinary incontinence and correction of prolapse of the genitals.
