RESUMEN
The main treatment for muscle-invasive bladder cancer is radical cystectomy with creation of an artificial intestinal bladder with restoration of transurethral urination is recognized as the best method of urine derivation. Aim - to study the urodynamic features of the artificial bladder. The main study group consisted of 57 patients with invasive bladder cancer who underwent radical cystoprostatectomy with ileocystoplasty in several specialized centers. The artificial bladder, formed from the terminal ileum, shows the original results of an urodynamic study, not similar to the data obtained with various pathologies of the bladder. Patients with severe atony of the neobladder were noted, which potentiated chronic mycotic insufficiency with elements of obstruction and required periodic catheterization. Some patients whose main complaint was urinary incontinence in the daytime and at night, according to the KUDI, demonstrated elements of the lack of overactivity, which can also be the cause of incontinence and requires further study of pathogenetic features and possible correction methods.
Asunto(s)
Neoplasias de la Vejiga Urinaria , Reservorios Urinarios Continentes , Cistectomía , Humanos , Íleon/cirugía , Masculino , Neoplasias de la Vejiga Urinaria/cirugía , UrodinámicaRESUMEN
The objective of the study was immunohistochemical evaluation of distribution of various NO synthase fractions in the structural elements of the bladder wall under stress urinary incontinence and its overactivity prior and post Mirabegron, Spasmex, Quercetin therapies and their combinations with Testosterone and Estradiol. Using the immunohistochemical method, we studied the expression of the main fractions of NO synthase in experimental models of hyperactive bladder (OAB) and stress urinary incontinence (SUI). We found that OAB and SUI were characterized by emergence of expression of the inducible fraction (iNOS) predominantly in the interstitial cells of the muscular layer of the bladder and reduced expression of endothelial (eNOS) and neuronal (nNOs) NO synthase fractions. In contrast to Spasmex, Mirabegron and Quercetin in combination with Testosterone and Estradiol contributed to stabilization of eNOS and nNOs expression already at early observation phases, and reduced the level of iNOS expression with its further disappearance in the later observation period.