ABSTRACT
Of late, we observe a trend to a progressive rise of overactive bladder (OB) morbidity with age. M-cholinolytic drugs are most effective in management of OB but old patients with prostatic adenoma (PA) and comorbid pathology have a risk of acute urinary retention and serious side effects. We have the experience in combined treatment of 30 old patients with PA and OB with M-cholinolytic and alpha-adrenoblocker. The results of the treatment show its efficacy and absence of complications in the control of residual urine for 3 months. Combination of M-cholinolytic with alpha-adreboblocker significantly reduced daily diuresis, improved an accumulation function of the bladder and life quality.
Subject(s)
Adrenergic alpha-Antagonists/administration & dosage , Cholinergic Antagonists/administration & dosage , Prostatic Hyperplasia/therapy , Urinary Bladder, Overactive/therapy , Adrenergic alpha-Antagonists/adverse effects , Age Factors , Aged , Cholinergic Antagonists/adverse effects , Diuresis/drug effects , Humans , Male , Middle Aged , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/mortality , Prostatic Hyperplasia/physiopathology , Quality of Life , Urinary Bladder, Overactive/complications , Urinary Bladder, Overactive/mortality , Urinary Bladder, Overactive/physiopathology , Urinary Retention/chemically induced , Urinary Retention/mortality , Urinary Retention/physiopathologyABSTRACT
Functional tests performed in patients with urine retention and cystostomic drainage help in detection of individual defects in urinary bladder function. Knowledge of the mechanisms causing the above defects allows individual approach to preoperative preparation and postoperative management of the patients, to pathogenetic medication improving its results.
Subject(s)
Cystostomy , Urinary Bladder/physiopathology , Urinary Retention/physiopathology , Urinary Retention/surgery , Urination , Adolescent , Adult , Aged , Humans , Male , Middle AgedABSTRACT
The study of efficacy of ozone therapy (OT) in preparation of patients with prostatic adenoma (PA) and cystostoma for transurethral resection (TUR) of PA included 20 PA patients with cystostomic drainage who had undergone PA TUR and preoperative preparation with OT sessions. The control group consisted of similar patients but without ozone pretreatment. OT efficacy was assessed by the rate of pyoinflammatory complications (PIC), results of immunological examination, positive changes in prostatic secretion, urine analysis, total blood count, degree ofbacteriuria. In the study group PIC (acute urethritis) developed in 1 patient, in the control--in 6 patients (3 cases of acute urethritis, 2 cases of acute prostatitis and 1 case of acute epididymitis). OT led to lowering of mean values of leukocyturia from 18.1 +/- 0.6 to 14.3 +/- 0.7 on the day of operation, to 10.9 +/- 0.7 after 4 days and to 8.7 +/- 0.6 on postoperative day 8 versus from 18.8 +/- 0.8 to 15.4 +/- 0.7, to 15.8 +/- 0.6 and 13.5 +/- 0.6, respectively. Mean control count of leukocytes in prostatic secretion fell in both groups. OT reduced bacteriuria. Number of bacteria to the day of operation decreased in both groups, but complete elimination of the agent from urine on day 8 was not achieved in the controls. The study group exhibited a rise in the absolute count of blood leukocytes, lymphocytes and ESR diminishing. OT raised significantly the phagocytic count and activity, concentration of mature T-lymphocytes (CD3), T-helpers (CD4), cytotoxic T-lymphocytes (CD8), B-lymphocytes (CD20), T-NK-cells (CD16), T-lymphocyte activation markers (CD3+, CD16+, CD56+, CD3+, CD25+, HLADR+, CD3+. The concentration of IgG, IgM, IgA remained high. Thus, the results of ozone application before PA TUR appeared promising in prevention of postoperative PIC.
