MEDICAL CORRECTION OF MEDICAL CORRECTION OF DISORDERS OF URINATION DISORDERS OF URINATION

AFTER THE TRANSURETHRAL AFTER THE TRANSURETHRAL RESECTION OF BENIGN RESECTION OF BENIGN

PROSTATIC HYPERPLASIA.PROSTATIC HYPERPLASIA.

О.О. О.О. StroyStroy, А., А.VV.. Shulyak, Borys B. Yu., J Shulyak, Borys B. Yu., J.О..О. Mytsyk Mytsyk, , VV..VV.. Dmytrienko Dmytrienko

Lviv National Medical University named after Danylo Halysky

IntroductionIntroduction.. According to autopsy data, BPH is found in 20% in the age According to autopsy data, BPH is found in 20% in the age

group 40-50 years, in 40% of males in the age group 50-60 group 40-50 years, in 40% of males in the age group 50-60 years.years.

There are over 100,000 BPH patients currently registered in There are over 100,000 BPH patients currently registered in Ukraine. Ukraine.

up to 70% - in 60-70 year-olds and 80% in the population of up to 70% - in 60-70 year-olds and 80% in the population of 70-80 years. 70-80 years.

The appearance of disuric symptoms after The appearance of disuric symptoms after TURP TURP in the in the immediate postoperative period is primarily related to immediate postoperative period is primarily related to inflammation and edema in the traumatized tissues.inflammation and edema in the traumatized tissues.

Taking into consideration the fact that in many instances the Taking into consideration the fact that in many instances the hyperplasic prostatic tissue is not entirely removed one of the hyperplasic prostatic tissue is not entirely removed one of the main reason of postoperative disorders of urination becomes main reason of postoperative disorders of urination becomes clear. clear.

ObjectivesObjectives..

The research purpose The research purpose was to explore was to explore efficiency of the efficiency of the combined medical combined medical correction of disorders correction of disorders of urination in patients of urination in patients with BPH after with BPH after transurethral transurethral resection.resection.

Materials and methodsMaterials and methods.. During research 95 patients were studied (main group) with During research 95 patients were studied (main group) with

BPH, in whom operating treatment was preformed the BPH, in whom operating treatment was preformed the transurethral resection of BPH.transurethral resection of BPH.

The following treatment was appointed in this group: a-1-The following treatment was appointed in this group: a-1-adrenoblocker “Setegys” (Terazozine) 2 mg once a day adrenoblocker “Setegys” (Terazozine) 2 mg once a day and herbal formula “Bodyprost” 1 tsp b.i.d. with meals. The and herbal formula “Bodyprost” 1 tsp b.i.d. with meals. The treatment was initiated on 4-6 day after surgery (after treatment was initiated on 4-6 day after surgery (after removal of the indwelling catheter) and lasted for a total of removal of the indwelling catheter) and lasted for a total of 4 weeks.4 weeks.

In order to compare treatment efficacy the control group In order to compare treatment efficacy the control group was created in which placebo was administered. The was created in which placebo was administered. The control group included 93 patients with BPH, in whom control group included 93 patients with BPH, in whom transurethral resection was performed as well.transurethral resection was performed as well.

The results of treatment were evaluated using the I-PSS The results of treatment were evaluated using the I-PSS symptom score, ultrasonography, prostatic secretions symptom score, ultrasonography, prostatic secretions composition, biochemical and clinical analyses of blood and composition, biochemical and clinical analyses of blood and urine, urodynamic studies.urine, urodynamic studies.

In the main group the assessment was performed before In the main group the assessment was performed before the treatment, on the 2-nd and on the 4-th week of the treatment, on the 2-nd and on the 4-th week of treatment. In the control group the assessment was treatment. In the control group the assessment was performed before treatment and on the 4-th week after the performed before treatment and on the 4-th week after the treatment.treatment.

The age of patients in both groups ranged 48-87 years. The age of patients in both groups ranged 48-87 years. Mean age of patients in the main group was 65,4±3,2 Mean age of patients in the main group was 65,4±3,2

years, in the control group 64,8±3,4 yearsyears, in the control group 64,8±3,4 years. .

Materials and methodsMaterials and methods..

Results and their discussion.Results and their discussion. Changes of clinical presentation in main group.Changes of clinical presentation in main group.

95 87

72 65

32

75 66

50 42

15

34

21 19 15 6

0

20

40

60

80

100

Symptom

%

Before treatment 95 87 72 65 32 2-nd week 75 66 50 42 15 4-th week 34 21 19 15 6

Frequency

Incomplete voiding

Difficuly voiding Urgency Incontinence

Results and their discussion.Results and their discussion. Changes of clinical presentation in control group.Changes of clinical presentation in control group.

93

81

69 67

28

60

53 36 42

20

0

20

40

60

80

100

Symptom

%

Before treatment 93 81 69 67 28 Week 4 28 19 15 12 20

Frequency Incomplete voidig

Difficulty voidig

Urgency

Incontinene

The same situation was observed in the The same situation was observed in the functio-nal studies of urinary tract before functio-nal studies of urinary tract before and after treatment:and after treatment:

The changes of maximal urine flow volume The changes of maximal urine flow volume (Qmax) in the main group was from (Qmax) in the main group was from 14,5±0,2 ml/sec to 16,3±0,3 ml/sec.14,5±0,2 ml/sec to 16,3±0,3 ml/sec.

The changes of maximal urine flow volume The changes of maximal urine flow volume in the control group was from 13,9±0,4 in the control group was from 13,9±0,4 ml/sec to 14,6±0,2 ml/sec.ml/sec to 14,6±0,2 ml/sec.

Results and their discussion.Results and their discussion.

Conclusions:Conclusions:

There was a positive therapeutic effect obtained There was a positive therapeutic effect obtained in the main group compared the control one in the main group compared the control one which speaks of the efficacy of combined medical which speaks of the efficacy of combined medical therapy of disuric conditions in patients with therapy of disuric conditions in patients with benign prostatic hyperplasia of Stage II after benign prostatic hyperplasia of Stage II after transurethral resection which allows to decrease transurethral resection which allows to decrease the appearance of disuric complications in the the appearance of disuric complications in the early postoperative periodearly postoperative period..

The proposed medical therapy has not caused The proposed medical therapy has not caused any serious adverse effects in patientsany serious adverse effects in patients, , which which demonstrated a high safety profile and possibility demonstrated a high safety profile and possibility of usage by patients with co-morbiditiesof usage by patients with co-morbidities..

Thank you Thank you for for attention!attention!