SU1395320A1 - Method of treatment of prophylaxis of complications after adenomectomy - Google Patents

Abstract

This invention relates to the field of medicine and can be used in logging to prevent complications after adenomectomy. The purpose of the invention is to increase the efficiency of the method by accelerating the treatment of urodynamic disorders, as well as preventing the development of sclerosis strictures and functional disorders. The method is carried out as follows. Patients using a rectal radiator are exposed to ultrasound at a frequency of 880-2640 kHz in a pulsed mode of 4-10 ms with an intensity of 0.2-0.4 W / cm for 3-5 minutes on the sphincter and bladder cheek areas daily before the procedures.

Description

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The invention relates to medicine, namely to urology, and is intended to prevent and eliminate complications after adenomectomy.

The purpose of the invention is to increase the effect that confirms the increase in intraurethral pressure required to open the sphincter, according to sphincterometry.

Example 2. Patient N Mr I. S., 68 years old

of the method by speeding up the treatment of 5 case history No. 575, entered urolurodynamic disorders, as well as the preliminary department of the Central Scientific Research Institute of Radiation and Epidemiology on March 11

prevention of stricture sclerosis and

functional impairment.

An example. Patient E. Yu. A, 67 years old,

1984 January 20, 1984 a transurethral resection of the prostate adenoma was performed. Postoperative

case history No. 58, admitted to the ur-Q course was complicated by urinary incontinence, the clinical department of the Central Research Institute of Physical and Radiotherapy and Publications on January 5 Complaints at admission for incontinence in 1984 on December 20, 1983, urine was produced, no urge to urinate. Single-moment adenomectomy and prostate-Objectively: AD-150/90 mmHg. Art. Tones

| gland, cystolithotomy, bilateral heart muted. In the lungs breathing vasoresection. Postoperative vesicular flow. No wheezing. Soft belly,

Complicated by urinary incontinence, which is 15 painless. The kidney area is painless after drug therapy and bugiroma. Postoperative ruby to satisfy

Vani did not stop and the patient was transferred to the Central Research Institute of Physics and Epidemiology.

rhythmic condition. The suprapubic suite is closed. Urine is released involuntarily into the urinal. An. urine: protein traces, leukocytes - 40-50 in p / sp, erythrocytes - O-1 in p / sp. AN urine by Nechiporenko: leukocytes - 4500, red blood cells - 68000 AN. blood: HB-13,4 g%. L -5100, ESR - 11 mm / h, blood urea - 3.12 mmol / l, creatinine blood -

I Complaints at admission to the complete retention of urine. Objectively. The general condition of the patient is satisfactory. Heart tones are muffled. BP-120/80 mm Hg Art. | B lungs vesicular breathing. No wheezing. The abdomen is soft, painless. The kidney area is painless. Postoperative leading condition. The suprapubic suite is closed. Urine is released involuntarily into the urinal. An. urine: protein traces, leukocytes - 40-50 in p / sp, erythrocytes - O-1 in p / sp. AN urine by Nechiporenko: leukocytes - 4500, red blood cells - 68000 AN. blood: HB-13,4 g%. L -5100, ESR - 11 mm / h, blood urea - 3.12 mmol / l, creatinine blood -

 vj ovjujiv onx3nna. i iu.; icuiicuci type UV-tc f nr / tr

cc in satisfactory condition, above-mmol / l. Cystomanometry: capacity pubic sishish closed. In a patient with a urinary bladder, when urging on the urine, it is continuously dripping into the urine: receiver. An. urine: protein traces ,. leukocytes, 15-20 in n / sp, erythrocytes

transmission - 100.0 ml. The maximum pressure in the bladder at the beginning of urination is 1000.0 mm of water. Art. Sphincte5 in sc. An. urine according to Nechyporenko: so - 320 mm. waters Art.

leukocytes - 30.000, red blood cells - 100.000. Treatment: ultrasound (apparatus

n blood: 2 g%. L-6000, ESR –UZT-3.05 U, frequency 2640 kHz), mode

| 16 mm / g. Sphincterometry: pressure - pulse - 4 ms, intensity -

YOO mm waters. Art. Renogra radioisotope-0.2 W / cm, the duration of the procedure

fi: Tmax: 3.5 minutes on the right, -5 minutes on the left, daily procedures, for a course of 10

3.5 min, T1 / 2: 7.5 minutes to the right, 35 procedures to the left. After treatment the patient’s condition

8.5 min improved: can hold about

Treatment: ultrasound rectal 100.0 ml of urine. There is no pain,

(UZT-103 device, frequency 880 kHz), urge urinating has reappeared. An.

Pulse press - 10 ms; intensity of urine: protein traces, leukocytes - 3-5 in p / zr,

0.4 W / cm, the duration of the process- ,, erythrocytes - 1-3 in p / sp. An. urine by

fools 5 min; daily procedures, Nechyporenko: leukocytes - 50Q red blood cells-

for a course of 12 treatments. After check-18000. AN blood: HB-13.0 g%. L-5800,

For this treatment, the patient's condition is SOE-10 mm / h. Cystomanometry: Capacity

improved, it is noted only in the uterine uterine bladder with the urge to urinate, and inadvertent discharge of several pulsations - 200.0. Maximum pressure

urine pelts at the end of urination, day45 the bladder at the beginning of the act urinate frequently, by itself, without painful discharges - 810 mm of water. Art. Sphincterostimus An. urine; protein is not. Ley-metri: pressure - 400 mm of water. Art.

kotsit - 5-7 in p / zr. An. urine from the Ne- this example shows that in the case of large-bore: leukocytes - 5.000, erythro-ny with the given parameters of ultrasound

cytes - 750. AN. blood: HB 13.6 g ° / increased the capacity of the bladder with POL-5900, ESR - 12 mm / h. Sphincterotect-50 due to urination, increased pressure: pressure - 400 mm of water. UF in the urethra, required for opening. As can be seen from this example, treatment, sphincter. All this was expressed in normanchatoe after 16 days. after surgery, the phase of accumulation and disappearance

prostate gland nomectomy, given in urinary incontinence, as well as in significant

a positive effect, expressed by the ICE, in is-reducing the activity of inflammatory urinary incontinence, in reducing the process in the lower urinary tract.

Example 3. Patient S. P.Ye., 68 years old, outpatient card I 3994, was sent to the Central Research Institute of Physics and Epidemiology for treatment for

inflammatory activity in the lower urinary tract, in improving the tone of the sphincter and bladder neck.

painless. The kidney area is painless. Postoperative ruby to satisfy

rhythmic condition. The suprapubic suite is closed. Urine is released involuntarily into the urinal. An. urine: protein traces, leukocytes - 40-50 in p / sp, erythrocytes - O-1 in p / sp. AN urine by Nechiporenko: leukocytes - 4500, red blood cells - 68000 AN. blood: HB-13,4 g%. L -5100, ESR - 11 mm / h, blood urea - 3.12 mmol / l, creatinine blood -

 f nr / tr

 mmol / l. Cystomanometry: capacity of the bladder when urging to the urine in the lower urinary tract.

Example 3. Patient S. P.Ye., 68 years old, outpatient card I 3994, was sent to the Central Research Institute of Physics and Epidemiology for treatment for

3

urinary incontinence October 14, 1983. In 1981, prostate adenomectomy and double-sided vasorection were produced. The postoperative course was complicated by urinary incontinence. Treatment: boiling of the urethra, washing the bladder with antiseptic solutions. There was no effect. In May 1983, he was consulted in the hospital. S.P. Botkin, where therapeutic physical training is recommended, uroanteptics are taken, general strengthening therapy. After treatment, there was no effect.

Objectively: BP-130/80 mmHg Art. The abdomen is soft, painless. The kidney area is painless. An. urine: protein - no, leukocytes - 0.1 in p / sp. An. blood: HB-13,6 g%. L-4700, ESR-3 mm / h. Cytomanometry: the capacity of the bladder at urge to urinate is 60.0 ml. The maximum pressure in the bladder - 580 mm of water Art. Sphincterometry: pressure - 260 mm of water. Art. At the institute, sinusoidal modulated currents were first treated to stimulate the sphincter of the bladder. After treatment: urinary incontinence remains the same. An ultrasound was rectally treated, the intensity was 0.4 W / cm, the pulsed mode was 10 ms, the procedure lasted 5 minutes a day, no. 10. After ultrasound treatment, urinary incontinence continues to disturb the patient. He walks with a urinal bag.

This example shows that the known methods of treatment of postoperative urinary incontinence did not produce an effect, and treatment with physical factors 2 g after the operation does not cause stimulation of the bladder sphincter due to irreversible changes occurring in the closing device of the bladder.

The proposed method of treatment was tested in the urology department of the Central Scientific Research Institute of Physics and Epidemiology in 32 patients with various complications after prostate adenomectomy. Patients came from various urological clinics in Moscow in the period from 14 to 30 days. after surgery. The main complaints at admission were: urinary incontinence (46.8%), urination in a thin and dull stream

5320

(35.0%

15

, frequent and nauseous urination (43.5%). All patients received treatment by the proposed method. After treatment, the performance improved.

from the functional state of the lower urinary tract. Thus, the capacity of the bladder during urination increased from 84.0 + 20.0 ml to 150.0 + 23.0 ml (, 05), the maximum pressure in the muscular bladder did not change at the beginning of urination and amounted to 580 , 0 + +35.0 mm of water. Art. (before treatment: 510.0 + + 27.0 mm of water. Art.,, 05). The pressure in the urethra required to open the sphincter, according to sphincterometry, increased from 290 + 35.0 mm of water. Art. up to 445.0+ + 42.0 mm of water. Art. (, 05). Of the 15 patients in whom urinary incontinence was the main complaint, after treatment, urination became independent in 8 patients, partial urinary incontinence was noted.

20 in the form of involuntary discharge of urine when walking, an abrupt change in body position in the morning in 4 patients, 2 patients were able to hold urine in the bladder in the amount of 80-100.0 ml and in one patient who was treated through 2 g after surgery, there was no effect.

In the rest of the patients, the frequency of urination returned to normal during the day;

30 disappeared and decreased pain and cramps during urination. Significant improvement was noted in 46.9% of patients, improvement in 46.8%, no change - in 6.3%

Claims (1)

Invention Formula 35 A method of treating and preventing complications after adeno-mectomy by acting on the lower urinary tract, characterized in that, in order to increase the effectiveness of the method by speeding up the treatment of urodynamic disorders and preventing the development of sclerosis strictures and functional disorders, patients in the early postoperative period use rectal radiator affect d5 on the sphincter and bladder neck with an ultrasound frequency of 880-2640 kHz in a pulsed mode of 4-10 ms, intensity of 0.2-0.4 W / cm daily echenie 3-5 minutes to 10-12 procedures. 40