NEW TECHNOLOGIES IN THE DIAGNOSIS AND REHABILITATION TREATMENT OF DYSURIA AFTER SURGICAL TREATMENT FOR PROSTATE CANCER
https://doi.org/10.17650/1726-9776-2012-8-1-82-87
Abstract
The paper deals with the latest neurophysiological technologies for the recognition and treatment of neurogenic disorders of urination and erection in a group of patients operated on for prostate cancer (PC). Acicular electromyography of pelvic floor muscles with transcranial magnetic stimulation of micturition and erectile centers has been put into practice to examine this category of patients. The basic neurophysiological parameters of the muscles examined (cortical and segmental evoked motor response the latency, central motor conduction time (CMCT), and motor unit potential (MUP) amplitude and duration) were estimated. To develop a normative base, the neurophysiological features of the pelvic floor were studied in healthy volunteers (n = 12) who formed a control group. Examinations were made in 17 patients who had undergone operations for PC at Moscow hospitals 3 to 18 months before, such as retropubic prostatectomy (n = 11) and transurethral resection plus high-intensity focused ultrasound (HIFU) ablation (n = 6). Spontaneous urination was absent in 4 (23.5%) of cases; urinary incontinence was observed in 6 (35.2%) patients. The study group patients were found to have significant disorders of corticospinal tract conduction and those of perineal muscle contraction as potential fibrillation and positive pointed waves, as well as considerable CMCM prolongation and MUP polyphasia. Denervation alterations in PC patients after surgery and delayed reinnervation processes, nerve control recovery are determined by not only the surgery itself, but also by the features of the course of the underlying cancer process. Pelvic floor muscle studies indicated that HIFU was a very traumatic treatment for PC due to the fact that physical exposure spread outside the prostate to the neuromuscular structures. The denervation alterations detected in the pelvic floor muscles became essential in the elaboration of adequate treatment policy. The use of agents improving the function and trophicity of peripheral nerves in combination therapy and the introduction of extracorporeal magnetic stimulation methods could largely improve the results of treatment for dysuria.
About the Authors
T. G. Markosyan
Federal Biomedical Agency of Russia
Russian Federation
Department of Rehabilitation Medicine, Sport Medicine, Balneology, and Physiotherapy
Russian Federation
Department of Rehabilitation Medicine, Sport Medicine, Balneology, and Physiotherapy
N. B. Korchazhkina
Federal Biomedical Agency of Russia
Russian Federation
Department of Rehabilitation Medicine, Sport Medicine, Balneology, and Physiotherapy
Russian Federation
Department of Rehabilitation Medicine, Sport Medicine, Balneology, and Physiotherapy
S. S. Nikitin
Research Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow
Russian Federation
Russian Federation
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Review
For citations:
Markosyan T.G., Korchazhkina N.B., Nikitin S.S. NEW TECHNOLOGIES IN THE DIAGNOSIS AND REHABILITATION TREATMENT OF DYSURIA AFTER SURGICAL TREATMENT FOR PROSTATE CANCER. Cancer Urology. 2012;8(1):82-87. (In Russ.) https://doi.org/10.17650/1726-9776-2012-8-1-82-87
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