Antibacterial and antiplaque efficacy of a lactoperoxidase-thiocyanate-hydrogen-peroxide-system-containing lozenge.

BACKGROUND: Antimicrobial agents are considered valuable adjuncts to mechanical methods of plaque control. However, their long-term use can be limited because of side effects. Therefore, using physiological substances is promising due to no risk of development, for example, of microbial resistances, allergies or DNA damaging. The lactoperoxidase-thiocyanate-hydrogen peroxide system (LPO-system) is a highly effective antimicrobial system. This study aimed to evaluate in a randomized study with a four-replicate cross-over design the effectiveness of two oral hygiene lozenges containing LPO-system in oral hygiene. RESULTS: After using the mouth rinse as positive control (A) and allocated test lozenges (B) (0.083% H2O2) & (C) (0.04% H2O2) for 4 days instead of the normal oral hygiene procedures (tooth brushing etc.), Listerine rinse (A) was statistically significantly more effective than the LPO-system-lozenge with 0.083% H2O2, the LPO-system-lozenge with 0.04% H2O2, and the placebo lozenge (D) in inhibiting plaque. Lozenges B and C were statistically significantly more effective than the placebo lozenge, but no statistically significant differences could be observed between them. The LPO-system-lozenge (B) reduced statistically significantly more S. mutans than the LPO-system-lozenge with (C) and the placebo lozenge (D). The LPO-system-lozenge (C) reduced statistically significantly more Lactobacilli than Listerine (A), the LPO-system-lozenge (B) and the placebo lozenge (D). There were no statistically significant differences in the total CFUs between Listerine rinse, the LPO-system-lozenge with 0.083% H2O2 (B), the LPO-system-lozenge with 0.04% H2O2 (C), and the placebo lozenge (D). On day 5 there were no differences of the OSCN--values between all A, B, C, and D. However, the SCN--values increased over the days in both LPO-system-lozenges (B/C). The statistically significant differences between B/C and A/D on day 5 were as followed: A to B p = 0.0268; A to C p = 0.0035; B to D p = 0.0051; C to D p = 0.0007. Only in the group of Listerine (A) increased the NO3-/NO2--quotient over the test time, which indicates a reduction of nitrate-reducing bacteria. On Day 5 the statistically significant difference between A and B was p = 0.0123. CONCLUSIONS: The results indicate that lozenges containing a complete LPO-system, inhibiting plaque regrowth and reducing cariogenic bacteria, may be used in the daily oral hygiene.

Urinary incontinence during pregnancy.

OBJECTIVE: An overview of urinary incontinence issues during pregnancy. DESIGN: A review article. SETTING: Department of Gynekology and Obstetrics, University Hospital Ostrava. CONCLUSION: Mechanisms leading to stress incontinence are multifactorial. Pregnancy and childbirth can lead to injuries or drowsiness of the pelvic floor muscles. The age of the firstborn and BMI in the pelvic floor disorders is similar to that of the end of pregnancy.

A rare complication of long-term vaginal prolapse.

OBJECTIVE: Description of rare complication of long-term uterine prolaps. Desing: Case report. SETTING: Department of Obstetric and Gynecology, University Hospital Ostrava. CASE REPORT: A seventy-years-old pacient with longterm complete uterine prolaps underwent vaginal hysterectomy with colpoclesis at department of Obstetric and Gynecology of university hospital Ostrava in August 2017. The surgery was planned more than year ago, when patient had no symptoms. But due to patient's injury, it was postponed and the condition was already complicated by urine incontinency. The surgery was complicated by bladder lesion, because it was suggested as a pelvis tumor. Correction of cystolithiasis was planned at a second time, when suprapubic cystoli-thotomy was performed after 16 days. Temporary urinary derivation was ensured by bilateral nephrostomy, epicystostomy and urinal catetrization for low residual bladder capacity after surgery. CONCLUSION: Bladder stones are a rare complication of otherwise relatively frequent complete urogenital prolaps in women. Major causes include micturition disorder and chronic urinary tract infection which is caused by vaginal and uterus descensus.

[Large hematoma - early postoperative complication after the transobturator tape procedure]. / Rozsáhlý hematom - casná komplikace po antiinkontinentní operaci transobturátorovým prístupem.

OBJECTIVE: To present a case report of the occurrence of large hematoma after the transobturator tape procedure. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, University Hospital Ostrava. CONCLUSION: The risk of vessel injury during the transobturator procedure is rare, but it is possible. The surgeons should be aware of the possibility and know possible solution. Conservative management of hematomas has been recommended when the patient is hemodynamically stable only without other secondary complications.

Persistence of subclinical sonographic joint activity in rheumatoid arthritis in sustained clinical remission.

BACKGROUND: Sonographic assessment, measuring grey scale (GS) and power Doppler (PD) signals, is a sensitive tool for the evaluation of inflammatory joint activity in patients with rheumatoid arthritis (RA). We evaluated the persistence of PD and GS signals in previously clinically active RA joints that have reached a state of continuous clinical inactivity. METHODS: We performed sonographic imaging of 22 joints of the hands of patients with RA, selected all joints without clinical activity but showing ongoing sonographic signs of inflammation, and evaluated the time from last clinical joint activity. RESULTS: A total of 90 patients with RA with 1980 assessed joints were included in this study. When comparing the mean time from clinical swelling, we found a significantly longer period of clinical inactivity in joints showing low sonographic activity (mean±SD time from swelling of 4.1±3.2 vs 3.1±2.9 years for PD1 vs PD≥2, p=0.031 and 4.5±3.4 vs 3.3±3.2 years for GS1 vs GS≥2, p≤0.0001). CONCLUSIONS: We conclude that subclinical joint activity is long-lasting in RA joints in clinical remission, but attenuates over time. The latter conclusion is based on the observed shorter time duration from last clinical activity for strong compared with weaker sonographic signals.

[Dorsal sagittal knee joint stability after endoprosthetic knee arthroplasty : Influence of preoperative joint stability and the type of implanted prosthesis]. / Dorsale sagittale Kniegelenkstabilität nach endoprothetischem Kniegelenkersatz : Einfluss der präoperativen Gelenkstabilität und des implantierten Prothesentyps.

BACKGROUND: Anterior knee pain is a known complication after implantation of a prosthesis and a possible reason is a posterior knee joint instability; however, the influence on postoperative stability is just as unknown as the possible influence of the type of prosthesis on postoperative stability. AIM: This study investigated two possible preoperative and intraoperative influencing factors by determination of the preoperative joint stability and type of prosthesis.

[Urinary incontinence induced by the antidepressants - case report]. / Mocová inkontinence indukovaná antidepresivy - kazuistické sdelení

AIM: Case study of the patient with urinary incontinence induced by the antidepressant mirtazapin and the review of the related literature. DESIGN: Case Report. SETTING: Department of Urology, University Hospital Ostrava-Poruba. CASE REPORT: A case of 55-years old patiens, who was reffered to the surgical treatment of the urinary incontinence. We found a major discrepancies during the evaluation that led us to suspect that this is not a common uncomplicated case of stress urinary incontinence. Based on the detailed history we identified the antidepressant mirtazapine as a likely causal factor. After discontinuing mirtazapin patient has achieved full control of the continence. CONCLUSION: Given that antidepressants affects adrenergic and dopaminergic regulatory mechanisms in the central nervous system, they may affect the lower urinary tract function. This work presents a case report where the disclosure of the less common cause of incontinence saved the patientoriginally proposed surgical treatment and allowed the effective restoration of the continence. We emphasize the need to consider the potential interaction of antidepressants with lower urinary tract function in daily practice.

[Bulking agents in the treatment of the stress urinary incontinence - current state and future perspectives]. / "Bulking agents" v lécbe stresové inkontinence moci - soucasný stav a budoucí perspektivy.

A review focused on minimally invasive treatment of the stress urinary incontinence using bulking agents provides a summary of the current knowledge on this subjects. This paper summarizes the findings on the mechanism of action, indications and applications technique, as well as clinical data on the efficacy and safety of the currently available bulking agents. Attention is also paid to possible future trends of this method. The work is designed to include specific implications for clinical practice.

[Importance of uroflowmetry in lower urinary tract symptoms diagnostics]. / Význam uroflowmetrie v diagnostice poruch dolních mocových cest.

OBJECTIVE: To summarize the current state of knowledge on the use of uroflowmetry in diagnosis of lower urinary tract dysfunction in women. DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, University Hospital Ostrava and Faculty of Medicine, Ostrava University. METHODS: Literature review. RESULTS AND CONCLUSION: Lower urinary tract dysfunction is associated with debilitating symptoms, which negatively affect the quality of life of a large number of patients, and represent a significant health problem. Inaccurate diagnosis leads to delayed therapy, which could cause disease progression and complications. It has been recently recognized that affected patients express a wide variety of clinical phenotypes. Advancements in diagnostic procedures may allow for individualized treatment and improved treatment outcomes. Diagnostic procedures recommended for patients with suspected lower urinary tract disease include directed medical history, urinalysis, voiding diary, as well as non-invasive and invasive urodynamic methods. Additional diagnostic tests may be used in select cases. Uroflowmetry is a basic urodynamic method used for screening. It represents a standard component used in the diagnostic process for patients with lower urinary tract symptoms. Sonouroflowmetry is a new method, which evaluates the urinary flow and lower urinary tract symptoms in a non-invasive manner by analysing the sound generated by a stream of urine striking the water surface in the toilet bowl.

[Intraindividual variability of uroflowmetry in women]. / Intraindividuální variabilita uroflowmetrického vysetrení u zen.

OBJECTIVE: The objective of this study was to determine the intraindividual variability of uroflowmetric measurement in women with normal lower urinary tract function. DESIGN: Prospective study. SETTING: Departure of obstetrics and gynecology University Hospital and Medical Faculty Ostrava. METHODS: 35 women without lower urinary tract dysfunction were enrolled into the study. Every subject uderwent 3 uroflowmetric examinations. We processed all numeric results. RESULTS: We assessed maximum and average urine flow rate - Qmax, Qave, voided volume - VV, corrected maximum urine flow and corrected average urine flow rate in every of 105 uroflowmetric´s measurements. We did not find any statistically significant difference for evaluation of intraindividual dispersion in studied parameters. CONCLUSION: Intraindividual variability of uroflowmetric´s measurement in healthy female subjects is low. One uroflowmetric´s measurement is adequate for assessment of uroflowmetric´s parameters.. KEYWORDS: uroflowmetry, intraindividual variability, lower urinary tract.

Effects of surface-bound and intravenously administered heparin on cell-surface interactions: inflammation and coagulation.

Intravenous administration of heparin and heparin-bonded extracorporeal circuits are frequently used to mitigate the deleterious effects of blood contact with synthetic materials. The work described here utilized human blood in a micro-perfusion circuit to experimentally examine the effects of intravenous and surface-bound heparin on cellular activation. Activation markers of coagulation and of the inflammatory response were examined using flow cytometry; specifically, markers of platelet, monocyte, polymorphonuclear leukocyte (PMN), and lymphocyte activation were quantified. The results indicate that surface-bound heparin reduces the inflammatory response whereas systemically administered heparin does not. This finding has important implications for blood-contacting devices, particularly within the context of recently elucidated connections between inflammation pathways and coagulation disorders. Data presented indicate that surface-bound heparin and intravenously administered heparin play distinct, but vital roles in rendering biomaterial surfaces compatible with blood.

[Intratympanic steroid administration: use in the treatment of profound idiopathic sudden sensorineural hearing loss]. / Intratympanale Dexamethasongabe: Nutzen in der Behandlung des hochgradigen Hörsturzes.

BACKGROUND: Therapy for idiopathic sudden sensorineural hearing loss is still controversial. Although there are no evidenced-based studies, therapy with systemic steroids is widely accepted as the gold standard. Intratympanic administration of steroids appears to be an alternative or additional method of management without the disadvantage of systemic side effects and, therefore, makes therapy accessible for patients with contraindication for systemic steroids. MATERIAL AND METHODS: This retrospective analysis compares the audiometric results of 25 patients who were treated with standard therapy (prednisolone, hydroxyethyl starch, pentoxyfylline) with 23 patients who additionally received intratympanic steroids (IT group). A total of 4 injections were administered within 10 days. The solution used consisted of 0.3 ml dexamethasone (8 mg/ml) and 0.2 ml hyaluronic acid 0.2%. The pure-tone average (PTA) was evaluated prior to and 3 months after treatment. RESULTS: The PTA 3 months after treatment showed an improvement of 48 dB in the IT group and 38 dB in the standard treatment group. The IT group achieved better recovery with an average PTA improvement of 68% compared to the standard treatment group with an average improvement of 59%. Neither result reached significance. CONCLUSION: Combination therapy with intratympanic steroids showed a tendency for better hearing results without serious side effects. However, because current evidence is not adequate, randomized placebo-controlled multicenter studies are needed.

Ketamine specifically reduces cognitive symptoms in depressed patients: An investigation of associated neural activation patterns.

Major depressive disorder (MDD) is characterized by heterogeneous cognitive, affective and somatic symptoms. Hence, the investigation of differential treatment effects on these symptoms as well as the identification of symptom specific biomarkers might crucially contribute to the development of individualized treatment strategies. We here aimed to examine symptom specific responses to treatment with ketamine, which repeatedly demonstrated rapid antidepressant effects in severe MDD. Additionally, we investigated working memory (WM) related brain activity associated with changes in distinct symptoms in order to identify specific response predictors. In a sample of 47 MDD patients receiving a single sub-anesthetic dose of ketamine, we applied a three-factor solution of the Beck Depression Inventory (BDI) to detect symptom specific changes 24 h post-infusion. A subsample of 16 patients underwent additional fMRI scanning during an emotional working memory task prior to ketamine treatment. Since functional aberrations in the default mode network (DMN) as well as in the dorsolateral prefrontal cortex (DLPFC) have been associated with impaired cognitive and emotional processing in MDD, we investigated neural activity in these regions. Our results showed that ketamine differentially affects MDD symptoms, with the largest symptom reduction in the cognitive domain. WM related neuroimaging results indicated that a more pronounced effect of ketamine on cognitive symptoms is predicted by lower DMN deactivation and higher DLPFC activation. Findings thereby not only indicate that ketamine's antidepressant efficacy is driven by a pro-cognitive mechanism, but also suggest that this might be mediated by increased potential for adaptive adjustment in the circumscribed brain regions.

Depression is associated with hyperconnectivity of an introspective socio-affective network during the recall of formative relationship episodes.

BACKGROUND: Depression and the experience of early adversity are associated with impairments in interpersonal and social cognitive functioning. The neural mechanisms involved in these impairments remain insufficiently understood. METHODS: In a sample of 48 depressed and 50 healthy participants, we explored seed-to-voxel functional connectivity (FC) during the recall of formative relationship episodes using functional magnetic resonance imaging. RESULTS: While depressive symptoms were associated with increased FC of brain regions that form an introspective socio-affective network, such as the precuneus, bilateral anterior insula, dorsal anterior cingulate cortex, left amygdala, and medial prefrontal cortex, early adversity linked to decreased FC of brain regions mediating emotion processing such as the bilateral anterior insula and increased FC of the bilateral parahippocampal gyrus. LIMITATIONS: We report both results that are corrected for the number of seeds tested in FC analyses using strict Bonferroni adjustments and unadjusted results as part of an exploratory analysis. DISCUSSION: Our findings suggest that depression and early adversity are associated with differential FC patterns in the brain during the recall of formative relationship episodes. Hyperconnectivity of an introspective socio-affective network associated with depressive symptoms may link to enhanced self-focus and emotional reactivity. Patterns of neural activation associated with early adversity may underpin numbed affective states or enhanced affective memory regulation. Overall, these findings inform about the neural underpinnings of a reflective ability that is predictive of the adaptation to depression and to early adversity and relevant for psychotherapy outcomes.

[Combination therapy with anticholinergics and alpha-blockers for the treatment of overactive bladder in female patients--pilot study]. / Kombinovaná lécba symptomu hyperaktivního mechýre anticholinergiky a alfalytiky u zen--pilotní studie.

INTRODUCTION: Overactive bladder (OAB) is one of the most common medical conditions with an estimated 16 percent of adult population being affected in Europe. The administration of anticholinergics is considered as the most frequent and most effective treatment. There is a evidence that alpha-blockers affect a detrusor function. The aim of the study is to investigate if the combinant therapy consisting of anticholinergics plus alpha-blockers could be beneficial for women suffering from OAB. MATERIAL AND METHODS: 28 female patients with OAB were included into the pilot study. Mean age of the patients was 54.8 (42-77) years. Patients have been randomised into two groups: one group of patients has been treated by propiverin 30 mg daily, another group of patients has been treated by combination of both propiverin 30 mg daily and tamsulosin 0.4 mg daily. Satisfaction with the treatment has been evaluated by I-QoL questionnaire. Semi-objective parameters have been obtained by analysis of 3-days voiding diaries (number of micturitions, number of urgency episodes, voided volume). Peak flow (Qmax) has been measured as a objective parameter. RESULTS: We observed a decrease of frequency by 2.833 (-23.43%) comparing to base-line, decrease of number of urgency episodes by 1.417 (-36.22%), increase of voided volume by 33.333 ml (+19.14%), increase of quality of life index by 22.583 (+51.52%) and increase of Qmax by 0.17 ml/s (+0.58%) in the propiverin group. We observed decrease of frequency by 3.813 (-30.48%), decrease of number of urgency episodes by 1.875 (-45.52%), increase of voided volume by 51.250 ml (+26.88%), increase of quality of life index by 33.438 (+76.0%) and increase of Qmax by 2.13 ml/s (+7.87%) in the combination treatment group. No significant difference has been found between both groups except the quality of life index. CONCLUSION: Our results can not show explicitly higher efficacy of combination treatment using anticholinergics plus alpha-blockers comparing to standard therapy by anticholinergics alone. Further randomised placebo-controlled studies are needed for final evaluation of the role of alpha-blockers in the treatment of OAB.

Herpes virus and Ménière's disease.

OBJECTIVE: The main goal of this study was to examine the vestibular ganglia from patients with intractable classic Ménière's disease (MD) for the presence or absence of DNA from three neurotropic viruses herpes simplex virus 1 and 2 (HSV1, HSV2) and varicella zoster virus (VZV) and to investigate the hypothesis that MD is associated with virus reactivation within Scarpa's ganglion. STUDY DESIGN: Polymerase chain reaction (PCR) was performed with nested primer sets specific for viral genomic DNA of HSV1, HSV2 and VZV in biopsies of the ganglion scarpae of patients with MD who underwent vestibular neurectomy. Included were patients with MD classified as definite MD according to American Academy of Otolaryngology/Head and Neck Surgery criteria. The ganglion scarpae and ganglion geniculi harvested at autopsy from patients without history of MD or facial palsy served as control specimens. RESULTS: No viral DNA was detected in the vestibular ganglion of 7 patients with definite MD. In 34% of the vestibular ganglia of the control group we detected either HSV1 or VZV. Only one Scarpa's ganglion had both viruses present at the same time. Thirty-two out of 34 ganglia from the geniculate segment of the facial nerve contained either HSV1 and/or VZV genomic DNA. Eight specimens contained both viruses simultaneously. Altogether viral DNA was found in 94% of ganglia. Viral genomic DNA of HSV2 was not detected. CONCLUSION: Although HSV and VZV appear to be present in many ganglion cells throughout the human body, we were unable to find genomic DNA of these viruses in patients with definite MD and disabling vertigo, who underwent vestibular neurectomy. Based on these results, reactivation of HSV1 and VZV in the vestibular ganglion does not seem to play a role in the pathogenesis of MD.

Different inflammatory responses of bovine oviductal epithelial cells in vitro to bacterial species with distinct pathogenicity characteristics and passage number.

The bovine oviduct provides the site for fertilization and early embryonic development. Modifications to this physiological environment, for instance the presence of pathogenic bacterial species, could diminish reproductive success at early stages of pregnancy. The aim of this study was to elucidate the inflammatory responses of bovine oviductal epithelial cells (BOEC) to a pathogenic bacterial species (Trueperella pyogenes) and a potentially pathogenic bacterium (Bacillus pumilus). BOEC from four healthy animals were isolated, cultured in passage 0 (P0) and passaged until P3. Trypan blue staining determined BOEC viability during 24 h co-culture with different multiplicities of infection (MOI) of T. pyogenes (MOI 0.01, 0.05, 0.1 and 1) or B. pumilus (MOI 1 and 10). BOEC remained viable when co-cultured with T. pyogenes at MOI 0.01 and with B. pumilus at MOI 1 and 10. Extracted total RNA from control and bacteria co-cultured samples was subjected to reverse transcription-quantitative polymerase chain reaction (RTq-PCR) to determine mRNA expression of various studied genes. The rate of release of interleukin 8 (IL8) and prostaglandin E2 (PGE2) from BOEC was measured by ELISA after 24 h co-culture with bacteria. RT-qPCR of various selected pro-inflammatory factors revealed similar mRNA expression of pro-inflammatory factors in BOEC co-cultured with T. pyogenes and in the controls. Higher mRNA expression of IL 1A, -1B, tumor necrosis factor alpha and CXC ligand (CXCL) 1/2, -3, -5 and IL8 and PG synthesis enzymes in BOEC co-cultured with B. pumilus was observed. In the presence of B. pumilus a higher amount of IL8 and PGE2 was released from BOEC than from controls. The viability and pro-inflammatory response of P3 BOEC incubated with bacteria was lower than in P0 BOEC. These findings illustrate the pathogenicity of T. pyogenes towards BOEC in detail and the potential role of B. pumilus in generating inflammation in oviductal cells. Culturing conditions influenced the pro-inflammatory responses of BOEC towards bacteria. Therefore, researchers conducting epithelial-bacterial in vitro co-culture should not underestimate the effects of these parameters.

Influence of intrauterine administration of Lactobacillus buchneri on reproductive performance and pro-inflammatory endometrial mRNA expression of cows with subclinical endometritis.

Potential beneficial effects of lactic acid bacteria on the genital health of cows become of particular interest when considering the importance of an optimal uterine health status for the success of breeding in dairy farming. Therefore, the aim of the present study was to analyse the influence of an intrauterine administration of the Lactobacillus buchneri DSM 32407 on reproductive performance, uterine health status, endometrial mRNA expression of pro-inflammatory factors of cows with signs of subclinical endometritis (SCE). L. buchneri DSM 32407 (n = 56; [LAC]) or a placebo (n = 60; [PLA]) was administered on day 24-30 postpartum. Endometrial cytobrush samples of cows with SCE were taken before the administration and at three following weeks (n = 16 cows each for LAC/SCE and PLA/SCE). A higher proportion of cows of the LAC and LAC/SCE group was pregnant after the first service and median days to conception for cows pregnant on day 200 pp were shorter. Three weeks after the administration, the endometrial mRNA expression of CXCL1/2, CXCL3, CXCR2, IL1B, IL8 and PTPRC was lower in the LAC/SCE group compared with the PLA/SCE group. These findings suggest that the presence of L. buchneri DSM 32407 contributes to a uterine environment that results in a better reproductive performance.

[Current condition of diagnosis and therapy of overactive urinary bladder in Czech Republic]. / Soucasný stav diagnostiky a lécby hyperaktivního mechýre v Ceské republice.

INTRODUCTION: The concept of overactive bladder (OAB), indicates complex symptoms of urgency, with or without urgent incontinence and it is generally accompained by urinary frequency and nocturia. Overactive urinary bladder belongs to one of the most common health problem in our population with significant impact on quality of life. The aim of this study is to assess this problem simultaneously between gynecologists and urologists in Czech Republic, by forwarding questionnaire. MATERIAL AND METHODS: There were 290 respondants who answered this assessment. Out of this total number, 181 were gynecologists, and 109 urologists. Of this total number, 104 gynecologists (57.5%) work in out-patient clinic, 21 of them (11.6%) in hospital, and 56 (30.9%) in both this departments. 31 of urologists (28.4%) work in out-patient clinic, 15 of them (13.8%) in hospital, and 63 (57.8%) in both this departments. Inquiry and questions included in questionnaire were espescially aimed at definition, diagnosis, and therapy of OAB. Results were worked by method of descriptive statistics, used instrumental method was anonym. RESULTS: Respondant gynecologists in the course of a week meet approx. 5.54 patients who suffering OAB, and respondant urologists meet in a week approx. 12.46 patients who suffering OAB. Correct definition of OAB mentioned only by 9 respondants (3.1%). At any rate, 57 respondants (19.6%) mentioned the basic symptoms i.e. urgency, urinary frequency, and urgent incontinence in their answer. Most common parameters employed for diagnosis of OAB including pt. history (280 respond. 965%), urine examination (255/87.5%), local urogynecological examination (247/85.2%), urodynamic investigation (183/63.1%), validated questionnaire (174/60%), voiding diary (139/47.9%), uroflowmetry (138/47.6%), and cystoscopy (134/46.2%). Most frequent therapeutic option is anticholinergic, followed by urinary bladder training, and application of local estrogen. CONCLUSION: Common knowledge about OAB problem is still low among experts and specialists. Diagnostic and therapeutic approach of OAB is significantly different between gynecology and urology. It is somehow advisable to have many centers in where the problem of OAB can be completely engaged and solved.

[Results of conservative non-pharmacological therapy in female patients with urinary incontinence]. / Výsledky konzervativní nefarmakologické terapie u pacientek s mocovou inkontinencí.

INTRODUCTION: The urinary incontinence belongs among the most frequent health problems especially in female population. Hundreds millions people suffer from urinary incontinence worldwide. This condition is not associated with a high morbidity or mortality; it influences the quality of life of affected patients however. The article assesses both subjective and objective results of the conservative non-pharmacological therapy and its effect to the quality of life in the set of female patients with urinary incontinence of all types. MATERIAL AND METHODS: The set totaled 69 female patients suffering from urinary incontinence treated by conservative non-pharmacological therapy. Patients with all type of incontinence (stress incontinence, urgent incontinence, mixed-type incontinence) of the Ist - IInd seriousness degree were included into the set. The average age of the set was 55 (19-80) years. All patients were treated in a complex way in accordance with principles of the so-called "Ostrava concept" of the conservative non-pharmacological therapy. Subjective results were evaluated using the visual-analog scale (VAS) while objective results were evaluated by the perineometric measurement of the pelvic floor. The quality of life was assessed using the I-QoL questionnaire. The assessment was performed before the therapy started and 6 months after. RESULTS: Before the therapy the value at VAS was 5.82, after the therapy the value at VAS was 2.73. The index of the quality of life in our set before the treatment was 55.6 (13.6-92.7), after the treatment it was 72.6 (22.7-98.7). The value of the maximum contraction force of the pelvic floor muscles before the treatment was 16.9 (5-51) cm H2O, after the treatment it was 17.4 (5-37) cm H2O, the mean value of the contraction force of the pelvic floor muscles before treatment was 10.8 (6-39) cm H2O, after the treatment it was 12.8 (3-33) cm H2O, average persistence time of the maximum contraction of pelvic floor muscles before the therapy was 5.5 (1-16) sec while after the therapy it changed to 9.1 (1-19) sec. CONCLUSION: Based on results obtained the conservative non-pharmacological therapy can be assessed as an efficient treatment method in case of the incontinence of Ist and IInd degree. Due to its non-invasive character and the absence of adverse effects it should be considered to be the first choice treatment in case of female patient with urinary incontinence.