Effect of M-cholinoblockers on the Clinical Course of Urinary Incontinence in Patients with an Artifical Bladder

Abstract

The objective: to study the M-cholinoblockers effect by urinary incontinence after the formation of an artificial bladder and to analyze the effectiveness of pharmacological correction on survival and quality of life. Materials and methods. 114 patients after radical cystectomy with the formation of a neobladder at various stages of the postoperative period involved in the study. The significant urinary incontinence of different degrees, which affected the patient’s quality of life, was determined in 27 (23.7%) persons who were included in solifenacin effect study group. To identify the degree of severity and the dynamics of recovery of the continence function, a questionnaire was conducted among patients who had urinary incontinence during the day and at night. With the help of a comprehensive study on the Delphis KT urodynamic unit, an analysis of urodynamic parameters in urinary incontinence was carried out. Results. After the formation of an artificial bladder, the patients had more stable daytime continence due to mental control over urination and understanding the need to urinate according to time. The situation was more complicated in patients with nocturnal urinary incontinence after radical cystectomy and the formation of an artificial bladder. However, after 2 weeks of treatment with solifenacin, patients had a significant improvement in the function of nocturnal urinary retention. After treatment with solifenacin patients had an improvement in daytime urinary retention by 37.2 % and nighttime urinary retention by 48.9 %. Two-week treatment with solifenacin significantly improved the patient’s quality of life and the dynamics of enterocystomanometry indicators, as evidenced by the results of control studies. The indicator of the subjective sensitivity level increased statistically significantly by 35.24 % compared to the group before treatment and amounted to 304.2±62.1 cm of water column (p≤0.05). The level of the first urge to urinate also increased reliably by 20.4 % – 458.2±81.0 cm of water column (p≤0.05). The level of urge to urinate was 636.1±92.8 ml (p≤0.05), which was statistically significantly higher by 17.5 % compared to patients who did not take solifenacin. Conclusions. The use of M-cholinoblockers in the correction of urinary incontinence in patients with an artificial urinary bladder due to the action on the smooth muscles of the intestines through parasympathetic innervation improves urodynamic indicators and the quality of life of the patients.