RU2509556C2 - Method of treating urethral syndrome in females - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely medicine, and may be used for treating urethral syndrome in females with using the antibacterial preparation gentamycin. Gentamycin is introduced into a urethral wall in the amount of 80 mg dissolved in anaesthetic solution 2 ml. The above preparation is introduced in parallel with the urethral wall. The anaesthetic is presented by 0.25% Novocaine. That is followed by a vulvar exposure to an infrared laser light at wave length 0.82 mcm, frequency 3000 Hz, and power 10 mWt. A procedure length makes 5-6 minutes; the therapeutic course is 8-10 procedures.

EFFECT: method is well tolerated, accessible and high effective by providing the high gentamycin concentration in the area of inflammation and stimulating repair processes.

1 ex, 2 tbl, 1 dwg

Description

The invention relates to medicine, namely to urology.

Violation of urination occurs in women often: up to 90% at least once in their life have experienced dysuria. Infectious and inflammatory diseases of the lower genital tract in women are widespread everywhere; a lot of scientific research has been devoted to this problem [1, 2].

Along with the classic acute or recurrent cystitis, when the clinical picture is clear and consists in frequent painful urination in the presence of bacteria in the urine, an increased content of leukocytes and red blood cells, the urethral syndrome is often formed. Urethral syndrome in women is caused by chronic inflammation of the skin's paraurethral glands (skinitis), inaccessible to antibacterial drugs with their standard purpose (per os, intramuscularly, intravenously). Patients with urethral syndrome are often mistakenly treated as patients with cystitis, and the correct diagnosis is established only in the case of suppuration of the skin glands, which requires a surgical manual.

Conventional antibiotic therapy with the administration of urotropic drugs (furamag, monural, ceforal) is the closest analogue, but these drugs are intended only for per os administration, local administration is impossible.

Gentamicin is a drug for parenteral administration, the therapy by intramuscular administration of gentamicin was adopted by us as a prototype. However, gentamicin injected into the gluteal muscle is distributed evenly throughout the body, without creating a peak concentration in the lesion.

In order to increase the concentration of drugs in the focus of inflammation and stimulate repair processes, a Method for treating the urethral syndrome in women with antibacterial drugs is proposed, characterized in that 80 mg of gentamicin dissolved in 2 ml of 0.25% novocaine is introduced into the urethral wall, followed by irradiation of the vulva with infrared laser radiation a wavelength of 0.82 microns, a frequency of 3000 Hz, a power of 10 mW, the duration of the procedure is 5-6 minutes, for a course of 8-10 procedures.

The method is as follows. The patient is placed in a gynecological chair with her legs spread, the external opening of the urethra is exposed by introducing a transparent, single-use Cuzco vaginal speculum. The external opening of the urethra and the anterior wall of the vagina are treated with a 1% aqueous solution of chlorhexidine, after which 80 mg of gentamicin per 2 ml of a 0.25% novocaine solution is injected parallel to the urethral wall. After that, the urethra region is irradiated with an infrared laser with the following parameters: wavelength 0.82 μm, radiation frequency - 3000 Hz, power - 10 MW. The duration of exposure is 5-6 minutes, 8-10 procedures per course.

After a course of treatment, the patient persistently stopped the pain syndrome, urination parameters were restored, dyspareunia stopped.

Example. Patient E., 24 years old. A history of defloration cystitis, chronic cystitis with frequent exacerbations. Nonspecific antibiotic therapy had an incomplete and short-term effect. When viewed from a chair, it was found: the walls of the urethra are thickened, painful on palpation; the external opening of the urethra is edematous. The treatment was carried out according to the proposed method for the treatment of urethral syndrome in women. 80 mg of gentamicin in a 2 ml 0.25% novocaine solution was injected into the urethral wall, followed by irradiation of the vulva with infrared laser wavelength 0.82 μm, frequency 3000 Hz, 10 mW, the duration of the procedure is 6 minutes, for a course of 10 procedures (considering the duration diseases and severity of clinical changes, the maximum duration of laser therapy and the maximum number of procedures were selected). After 10 days the pain is completely stopped, urination is free, painless, uroflowmetric indicators are normal.

A method for the treatment of urethral syndrome in women was tested at the FGBI NNIIT in six patients; the results are presented in tables 1 and 2 and in the diagram.

Table 1 Dynamics of uroflowmetry data during treatment Indicator Originally After treatment V (ml) 165.2 253.7 T voiding (s) 16.5 18.7 Q max (ml / s) 19.7 27.1 Q ave (ml / s) 5,0 12.8

As follows from table 1, the initial bladder volume in patients averaged only 165.2 ml, after treatment increased to 253.7 ml. After treatment, both average (Q ave) and maximum (Q max) urine flow rates increased significantly.

table 2 The severity of clinical manifestations initially (abs. /%), n = 6 Symptom / Score 0
no sign one
weak 2
unsharp 3
moderate four
strong 5
very strong Bladder pain 0 0 0 27.8% 22.2% 50.0% Imperative urge 0 0 0 52.8% 27.8% 19.4% Burning at the end of urination 0 0 0 47.2% 33.3% 19.4% Discomfort after urinating 0 0 5.5% 13.9% 38.9% 31.7%

From table 2 it follows that when included in the study, all patients had serious urination disorders, with pronounced complaints; their change during treatment is reflected in the diagram (see Fig.). Starting from the first day, all patients noted a decrease in urethral pain, by the 7th day - an improvement in urine tests to normalize in most of them, and by the 10th - recovery. The proposed method is highly effective, well tolerated, available for use both in hospitals and on an outpatient basis.

LITERATURE

1. Pushkar D.Yu., Zaitsev A.V., Godunov B.N., Davidyants A.A. Diagnosis and treatment of various forms of cystitis in women. - M., 2002 - 39 p.

2. Rafalsky V.V., Strachunsky L.S., Kogan M.I. et al. Antibacterial therapy of complicated urinary tract infections in outpatients. // Urology. - 2004. - No. 5. - S.25-31.

Claims (1)

A method of treating the urethral syndrome in women with an antibacterial drug gentamicin, which is injected into the urethral wall in an amount of 80 mg dissolved in 2 ml of an anesthetic solution, characterized in that the administration is carried out parallel to the urethral wall, and a 0.25% solution of novocaine is introduced as an anesthetic followed by irradiation of the vulva with infrared laser radiation with a wavelength of 0.82 microns, a frequency of 3000 Hz, a power of 10 mW, the duration of the procedure is 5-6 minutes, a course of 8-10 procedures.

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