Расширенный поиск


Полный текст:


The incidence of urinary incontinence after radical prostatectomy is 0.8 to 87%. This category of patients has pelvic floor muscle weakness and reduced perineal reflex. The treatment of these patients uses a pelvic floor exercise system that is to enhance muscle tone and to develop strong reflex contraction in response to a sudden rise in intraabdominal pressure. Pelvic floor muscle training belongs to first-line therapy for urinary incontinence occurring within 6 to 12 months after prostatectomy. The ability to control pelvic floor muscle knowingly and to train them allows one not only to increase the closing capability of sphincter mechanisms, but also to suppress involuntary detrusor contractions. We used this method in 9 patients who had undergone radical prostatectomy. The duration of pelvic floor muscle training under control was up to 25 weeks. During this period, the symptoms of incontinence were relieved. No contraindications or adverse reactions have put this method in first-line therapy for post-prostatectomy urinary incontinence.

Об авторах

Ю. Л. Демидко
Урологическая клиника ММА им. И.М. Сеченова

Л. М. Рапопорт
Урологическая клиника ММА им. И.М. Сеченова

М. Е. Чалый
Урологическая клиника ММА им. И.М. Сеченова

Е. А. Безруков
Урологическая клиника ММА им. И.М. Сеченова

Д. Г. Цариченко
Урологическая клиника ММА им. И.М. Сеченова

Л. С. Демидко
Урологическая клиника ММА им. И.М. Сеченова

А. З. Винаров
Урологическая клиника ММА им. И.М. Сеченова

А. А. Левко
Урологическая клиника ММА им. И.М. Сеченова

Список литературы

1. Walsh P.C., Marschke P., Ricker D., Burnett A.L. Patientreported urinary continence and sexual function after anatomic radical prostatectomy. Urology 2000;55:58-61.

2. Rudy D.C., Woodside J.R., Crawford E.D. Urodynamic evaluation of incontinence in patients undergoing modified Campbell radical retropubic prostatectomy: a prospective study. J Urol 1984;132:708-12.

3. Augustin H., Pummer K., Daghofer F. et al. Patient self-reporting questionnaire on urological morbidity and bother after radical retropubic prostatectomy. Eur Urol 2002;42:112-7.

4. Прести Дж. Опухоли предстательной железы. В кн.: Урология по Дональду Смиту. Под ред. Э. Танахо и Дж. Мак-анинч. М.: Практика, 2005.

5. Burkhard F.C. Kessler T.M., Fleischmann A. et al. Nerve-sparing open radical retropubic prostatectomy-does it have an impact on urinary continence? J Urol 2006;176:189-95.

6. Коган М.И., Лоран О.Б., Петров С.Б. Радикальная хирургия рака предстательной железы. М.: ГЭОТАР-Медиа, 2006.

7. Безруков Е.А. Выбор метода лечения при локализованном и местно-распространенном раке простаты. Автореф дис. докт. мед. наук. М., 2008.

8. Оха У.К., Логью Дж. Рак простаты. М.: Рид Элсивер, 2009.

9. Wei J.T., Dunn R.L., Marcovich R. et al. Prospective assessment of patient reported urinary continence after radical prostatectomy. J Urol 2000;164:744-8.

10. Wei J.T., Montie J.E. Comparison of patients' and physicians' rating of urinary incontinence following radical prostatectomy. Semin Urol Oncol 2000;18:76-80.

11. Hammerer P., Huland H. Urodynamic evaluation of changes in urinary control after radical retropubic prostatectomy. J Urol 1997;157:233-6.

12. Kundu S.D., Roehl K.A., Eggener S.E. et al. Potency, continence, and complications in 3477 consecutive radical retropubic prostatectomies. J Urol 2004;172:2227-31. 13. Catalona W.J., Carvalhal G.F.,

13. Mager D.E., Smith D.S. Potency, continence, and complication rates in 1870 consecutive radical retropubic prostatectomies. J Urol 1999;162:433-8.

14. Eastham J.A., Kattan M.W., Rogers E. et al. Risk factors for urinary incontinence after radical prostatectomy. J Urol 1996;156:1707-13. 15. Van der Horst C., Naumann C.M.,

15. Al-Najaar A. et al. Etiology and pathophysiology of male stress incontinence. Urologe 2007;46:233-9.

16. O'Donnell P.D., Finan B.F. Continence following nervesparing radical prostatectomy. J Urol 1989;142:1227-8.

17. Nelson C.P., Montie J.E., McGuire E.J. et al. Intraoperative nerve stimulation with measurement of urethral sphincter pressure changes during radical retropubic prostatectomy: a feasibility study. J Urol 2003;169:2225-8.

18. Foote J., Yun S., Leach G.E. Post-prostatectomy incontinence. Pathophysiology, evaluation, and management. Urol Clin North Am 1991;18: 229-41.

19. Khan Z., Mieza M., Starer P., Singh V.K. Post-prostatectomy incontinence. A urodynamic and fluoroscopic point of view. Urology 1991;38:483-8.

20. Melekos M. et al. Changes of urodynamic findings after radical retropubic prostatectomy. Eur Urol 1999;35:217-22, discussion 21-2.

21. Porena M., Mearini E., Mearini L. et al. Voiding dysfunction after radical retropubic prostatectomy: more than external urethral sphincter deficiency. Eur Urol 2007;52:38-45.

22. Carlson K.V., Nitti V.W. Prevention and management of incontinence following radical prostatectomy. Urol Clin North Am 2001;28:595-612.

23. Groutz A., Blaivas J.G., Chaikin D.C. et al. The pathophysiology of post-radical prostatectomy incontinence: a clinical and video urodynamic study. J Urol 2000;163:1767-70.

24. Noguchi M., Shimada A., Nakashima O. et al. Urodynamic evaluation of a suspension technique for rapid recovery of continence after radical retropubic prostatectomy. Int J Urol 2006;13:373-8.

25. Ravery V. How to preserve continence after radical prostatectomy. Eur Urol Suppl 2005;4(4):8-11.

26. Hellstrom P., Lukkarinen O., Kontturi M. Urodynamics in radical retropubic prostatectomy. Scand J Urol Nephrol 1989;23:21-4.

27. Licht M.R., Klein E.A., Tuason L.,Levin H. Impact of bladderneck preservation during radical prostatectomy on continence and cancer control. Urology 1994;44:883-7.

28. Wille S., Varga Z., von Knobloch R.,Hofmann R. Intussusception of bladder neck improves early continence after radical prostatectomy: results of a prospective trial. Urology 2005;65:524-7.

29. Poon M., Ruckle H., Bamshad B.R. et al. Radical retropubic prostatectomy: bladder-neck preservation versus reconstruction. J Urol 2000;163:194-8.

30. Brasa K.G., Petsch M., Lim A. et al. Bladder neck preservation following radical prostatectomy: continence and margins. Eur Urol 1995;28:202-8.

31. Jarow J.P. Puboprostatic ligament sparing radical retropubic prostatectomy. Semin Urol Oncol 2000;18:28-32.

32. Myers R.P. Male urethral sphincteric anatomy and radical prostatectomy. Urol Clin North Am 1991;18:211-27.

33. Poore R.E., McCullough D.L.,Jarow J.P. Puboprostatic ligament sparing improves urinary continence after radical retropubic prostatectomy. Urology 1998;51:67-72.

34. John H., Hauri D. Seminal vesiclesparing radical prostatectomy: a novel concept to restore early urinary continence. Urology 2000;55:820-4.

35. Rocco B., Gregori A., Stener S. et al. Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal videolaparoscopic radical prostatectomy. Eur Urol 2007;51:996-1003.

36. Rocco F., Carmignani L., Acquati P. et al. Restoration of posterior aspect of rhabdosphincter shortens continence time after radical retropubic prostatectomy. J Urol 2006;175:2201-6.

37. Cambio A.J., Evans C.P. Minimising postoperative incontinence following radical prostatectomy: considerations and evidence. Eur Urol 2006;50:903-13, discussion 13.

38. Аль-Шукри С.Х., Кузьмин И.В. Метод биологической обратной связи в лечении недержании мочи. Урология 1999;(5):44-7.

39. Hunter K.F., Moore K.N., Cody D.J.,Glazener C.M. Conservative management for post-prostatectomy urinary incontinence. Cochrane Database Syst Rev CD001843, 2004.

40. Nahon I., Dorey G., Waddington G.,Adams R. Systematic review of the treatment of post-prostatectomy incontinence. Urol Nurs 2006;26:461-75, 82.

41. MacDonald R., Fink H.A.,Huckabay C. et al. Pelvic floor muscle training to improve urinary incontinence after radical prostatectomy: a systematic review of effectiveness. BJU Int 2007;100:76-81.

42. Bales G.T., Gerber G.S., Minor T.X. et al. Effect of preoperative biofeedback/pelvic floor training on continence in men undergoing radical prostatectomy. Urology 2000;56: 627-30.

43. Filocamo M.T., Li Marzi V.,Del Popolo G. et al. Effectiveness of early pelvic floor rehabilitation treatment for postprostatectomy incontinence. Eur Urol 2005;48:734-8.

44. Floratos D.L., Sonke G.S.,Rapidou C.A. et al. Biofeedback versus verbal feedback as learning tools for pelvic muscle exercises in the early management of urinary incontinence after radical prostatectomy. BJU Int 2002;89: 714-9.

45. Van Kampen M., De Weerdt W.,Van Poppel H. et al. Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: a randomised controlled trial. Lancet 2000;355:98-102.

46. Крупин В.Н., Белова А.Н. Недержание мочи. В кн.: Нейроурология. М., 2005.

47. Bulmer P., Abrams P. The unstable detrusor. Urol Int 2004;72(1):1-12.

48. Seckiner I., Yesilli C., Mungan N.A. et al. Correlations between the ICIQ-SF score and urodynamic findings. Neurourol Urodyn 2007;26:492-4.

49. Abrams P., Cardozo L., Fall M. et al. The standardisation of terminology of lower urinary tract function: report from the standardization subcommittee of the international continence society. Am J Obstet Gynecol 2002;187:116-26.

50. Abdel-Fattah M., Barrington J.W.,Youssef M. The standard 1-hour pad test: does it have any value in clinical practice? Eur Urol 2004;46:377-80.

Для цитирования:

Демидко Ю.Л., Рапопорт Л.М., Чалый М.Е., Безруков Е.А., Цариченко Д.Г., Демидко Л.С., Винаров А.З., Левко А.А. ТРЕНИРОВКА МЫШЦ ТАЗОВОГО ДНА В ЛЕЧЕНИИ НЕДЕРЖАНИЯ МОЧИ ПОСЛЕ РАДИКАЛЬНОЙ ПРОСТАТЭКТОМИИ. Онкоурология. 2010;6(1):45-49.

For citation:

Demidko Yu.L., Rapopert L.M., Chalyi M.E., Bezrukov E.A., Tsarichenko D.G., Demidko L.S., Vinarov A.Z., Levko A.A. PELVIC FLOOR MUSCLE TRAINING IN THE TREATMENT OF URINARY INCONTINENCE AFTER RADICAL PROSTATECTOMY. Cancer Urology. 2010;6(1):45-49. (In Russ.)

Просмотров: 671

Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.

ISSN 1726-9776 (Print)
ISSN 1996-1812 (Online)