Conservative treatment of urinary incontinence after transurethral resection of the prostate

Introduction. Among the existing methods of surgical treatment of patients with benign prostatic hyperplasia (BPH) transurethral resection (TUR) of the prostate is the most widely used. Due to the long-term improvement of the technique, non-lethal complications are now more characteristic of this operation. These include postoperative urinary incontinence, which dramatically reduces the quality of life of patients and casts doubt on the effectiveness of the operation performed. Stress urinary incontinence, the most common type of disorder, basically has sphincter insufficiency associated with iatrogenic damage to the external closure apparatus of the bladder when it goes beyond the distal border of resection in TUR BPH. However, an equally important role in the genesis of sphincter insufficiency belongs to the inflammatory process, which always accompanies trauma to muscle structures during surgery. The aim of this prospective study was to improve outcomes in patients with urinary incontinence after TUR BPH. Materials and methods. The study involved 86 patients who underwent TUR BPH, with the leading complaint of urinary incontinence. Patients were divided into 2 groups, initially comparable in terms of the main evaluated criteria. Patients of the first (control) group (n=30) received complex antibacterial and anti-inflammatory therapy, according to indications - alpha-blockers, prostatotropic regulatory biopeptides and enzyme preparations, in the presence of a hyperactivity component - M-anticholinergics and / or a selective agonist of β3 adrenoreceptors. Patients of the second (main) group (n=56) for the purpose of long-term anti-inflammatory effects and reduce the pharmacological load additionally received the phytocomplex «Profilaprost» 1 capsule per day for 2 months. Result. In the main group of patients who received the «Profilaprost» complex, after 2.5 months from the start of therapy, we recorded an improvement in the reservoir function of the bladder. In 65% of patients, complete continence was achieved, in 20% - stabilization of incontinence at a mild degree, requiring no more than one safety pad per day, in another 10% the result can be described as not quite satisfactory - the frequency and degree of incontinence decreased, but persisted the level of symptoms was considered unacceptable by the patients and insisted on continuing treatment. And only in 5% of patients, complex therapy had no effect. A decrease in IPSS and QoL indices, an improvement in continence significantly correlated with a decrease in the degree of leukocyturia. Conclusion. The herbal-mineral complex «Profilaprost» showed good efficacy with no side effects and adverse events in the treatment of urinary incontinence after TURP.