[Onto-phylogenetic prerequisites for development of chronic cystitis in women].

INTRODUCTION: Urinary tract infections (UTIs) are among the most common bacterial infections. At the request "cystitis", there are 12,067 publications in the RSCI system (e.library) as of 10/08/2023 and 16,332 articles were screened in the Pubmed. This is evidence that the problem of cystitis is far from being resolved. MATERIAL AND METHODS: A total of 425 patients with bacterial vaginosis and 77 women with chronic recurrent cystitis were included in the study. In all patients, the vaginal biocenosis was assessed through molecular genetic testing. The examination included filling out the Russian version of the Acute Cystitis Symptom Score (ACSS), urinalysis, and urine culture. In addition, local microcirculation was measured using laser Doppler flowmetry (LDF). After examination, patients were prescribed basic therapy and randomly assigned to one of three groups. In a control group (n=17), only basic therapy, consisting of fosfomycin 3.0 once at night + furagin 100 mg after meals 3 times a day for 5 days was prescribed. In the main group 1, 29 women received basic therapy plus Superlymph suppositories 10 units 2 times a day vaginally for 10 days. In the main group 2, 31 patients received basic therapy plus suppositories Superlymph 10 units (rectally in the morning) and Acylact Duo (vaginally in the evening) for 10 days. RESULTS: Among 425 patients with bacterial vaginosis, 78 (18.3%) complained of various urinary disorders, but only 21 women (4.9% of those with vaginal dysbiosis and 26.9% with dysuria) had a diagnosis of cystitis. In all cases, it was an exacerbation of a chronic disease. Among 77 patients with chronic cystitis, normal vaginal flora was initially present in 32 patients (41.6%), and bacterial vaginosis was found in 45 (58.4%) cases. After therapy, positive results were noted in patients of all groups. Complete eradication of the pathogen occurred in 15 women (88.2%) who received only basic therapy; in the main groups 1 and 2, uropathogens were not detected in 27 (93.1%) and 28 (90.3%) cases, respectively. In the control group, the proportion of patients with normal vaginal flora remained virtually unchanged (41.2% [n=7] vs. 47.1% [n=8]). In the main group 1, the proportion of patients with normal vaginal flora almost doubled: from 41.4% (n=12) to 79.3% (n=23). In main group 2, restoration of vaginal flora was noted in 87.1% of cases. CONCLUSION: According to our data, only 4.9% of patients with bacterial vaginosis were diagnosed with chronic cystitis, however, 58.4% of patients with chronic cystitis had vaginal dysbiosis. The use of a complex of antimicrobial peptides and cytokines has significantly increased the bidirectional effect of therapy. Suppositories Superlymph in a combination with vaginal use of Acylact Duo allow to obtain the best results.

[Charasteristics of the treatment of urinary disorders in postmenopausal women].

INTRODUCTION: Overactive bladder syndrome (OAB) is very common. It has been shown that urge incontinence is more difficult for women than for men, sinse they have higher levels of stress, depression, and more pronounced sexual dysfunction. MATERIAL AND METHODS: The study included 47 patients aged 54.6+/-3.5 years with symptoms of OAB. The Overactive Bladder Symptom Score (OABSS) was used to assess the symptoms, while the sexual function of the patients was evaluated using the Female Sexual Dysfunction Index (FSFI). In addition, Mini Mental State Examination (MMSE) scale was used for assessing the cognitive function. In comparison group there were 22 women who were comparable in socio-demographic characteristics, but didnt have symptoms of OAB. The comparison between two groups was carried out using FSFI scale. Patients in the OAB group were prescribed trospium chloride (Spazmex) 15 mg b.i.d. for three months, after which the patients completed the OABSS, FSFI, and MMSE questionnaires again. RESULTS: All patients with OAB reported sexual dysfunction, which was significantly more profound than in the control group. The FSFI scores were, respectively, 15.23+/-6.12 versus 22.46+/-5.47. The average assessment of the cognitive abilities of patients with OAB was 27.9+/-1.4, which indicates that their cognitive functions were completely intact. The mean score on the OABSS scale was 11.8+/-2.7, and 11 women (23.4%) had a mild OAB, and 36 (76.6%) had moderate severity of symptoms. After three months of therapy, the mean score on the OABSS scale decreased by half, to an average of 5.4+/-1.2 points; the overall score of the FSFI approached the level of healthy women (20.64 and 22.46, respectively). The repeated assessment of the mental status did not reveal any changes, since the mean score of MMSE was 27.8+/-1.3. No significant adverse events were noted in any case. None of the patients required dose adjustment of the drugs that they received for concomitant diseases. CONCLUSION: All women with OAB syndrome had decreased sexual function compared to healthy women of the same age and social status. A three-month course of trospium chloride (Spazmex), 30 mg daily, significantly improved both the parameters of urination and the sexual function, without having any adverse effect on their cognitive abilities. Moreover, there was no need to adjust the doses of drugs taken for concomitant diseases.