[Language, cultural adaptation and validation of the OABSS (Overactive Bladder Symptom Score) questionnaire in patients with overactive bladder].

AIM: To perform language and cultural adaptation and validation of the OABSS (Overactive Bladder Symptom Score) questionnaire among patients with overactive bladder (OAB), proposed as an effective tool for assessing the severity of symptoms and the efficiency of treatment in clinics of the Russian Federation. MATERIALS AND METHODS: In accordance with the protocols for carrying out such studies, the procedure of standardized forward-backward translation of the OABSS questionnaire was performed. Further, the intermediate Russian-language version was applied to 15 patients with subsequent correction of deficiencies and approval of the final Russian-language version of the questionnaire. In total, the study group included 176 patients of both sexes with OAB symptoms who filled out the questionnaire twice (test-retest) with an interval of 10-14 days. RESULTS: Based on the statistical analysis (Cronbach's alpha = 0.961), there was a significant degree of internal consistency of the sample. This fact is also supported by the very high retest reliability of the questionnaire (ICC >0.9). CONCLUSION: Our data showed that the Russian version of the OABSS questionnaire is a reliable and valid tool for subjective assessment of the severity of OAB symptoms.

[bobotulinum toxin A (Dysport) for the treatment of neurogenic detrusor overactivity].

Increasing of treatment efficiency in patients with neurogenic detrusor overactivity is an important medical and social problem. Its significance is determined not only by the high prevalence of neurogenic lower urinary tract dysfunctions, but also by the high risk of complications, among which an impaired renal function takes the leading place. Botulinum toxin therapy is considered as a second-line treatment and is carried out in case of insufficient efficacy, unsatisfactory tolerability or the presence of contraindications to anticholinergic therapy. Botulinum toxin therapy has been actively used in our country for more than 12 years. In 2022, abobotulinum toxin A (Dysport) was registered in the Russian Federation for the treatment of neurogenic detrusor overactivity. An overview of the results of clinical trials of Dysport, indicating its high efficacy and favorable safety profile, is presented in the article. The availability of botulinum toxin in the arsenal of a urologist, which has a high efficiency, opens up additional prospects for the treatment of patients with a neurourological profile.

[MIRABEGRON. WHETHER WILL BE A REVOLUTION IN THE PHARMACOTHERAPY OF OVERACTIVE BLADDER?].

This article provides an overview of the current state of the problem of effective pharmacotherapy for overactive bladder (OAB). The review presents standard pharmacotherapy and a new stage in the treatment of OAB--innovative drug Mirabegron. International and domestic studies confirmed high and predominant in many respects efficacy of mirabegron and a good safety profile. Conducted at the Research Institute of Urology own research demonstrated no influence on the quality of the bladder emptying, which proves the urodynamics safety. Taking into account the efficacy of mirabegron for all OAB symptoms, proven in a Randomized Clinical Tials (RCT), mirabegron has big potential and is able to make a revolution in the pharmacotherapy of OAB.

[The role of dysfunction of the autonomic nervous system in idiopathic overactive urinary bladder in women].

A complex urological and neurological examination of female patients with idiopathic overactive bladder (IOAB) has detected clinical signs and neurophysiological correlates of vegetative dysfunction in the form of disturbed sympatho-parasympathic interrelations, failure of segmental and compensatory enhancement of suprasegmental mechanisms of regulation of lower urinary tract activity. The treatment with selective inhibitors of serotonin re-entry reduced severity ofpsychovegetative syndrome and symptoms of the lower urinary tract. This confirms an essential role of the autonomic nervous system in pathogenetic mechanisms of IOAB development and gives grounds for recommending selective inhibitors of serotonin re-entry for combined treatment of IOAB patients.

[The method of a complete one-stage urogenital reconstruction in extrophy of the urinary bladder and total epispadia in the adults].

In the context of surgical treatment of bladder extrophy/epispadia in the adults, the authors offer one-stage urogenital reconstruction, i.e. urethro-corporo-glanulo-sphyncteroplasty with penile preparation. Long-term results were analysed in adult patients with total epispadia and urine incontinence. Intact erectile function was observed in all 25 patients. An adequate function of the artificial muscular sphyncter was registered in 20 patients. The length of the penis increased from 2.5 to 5 cm. Sexual adaptation was achieved in 88% cases. Social adaptation occurred in all the cases.

[Quality of life in patients after radical prostatectomy].

According to the literature, after radical prostatectomy the patients had normal micturition and erectile function in 50 and 10-30%, respectively. A total of 647 patients with diagnosis prostatic cancer (PC) stage T1a-T4 were examined in two clinics in 1997-2003. Of them, 43 patients (PC stage T1a-T3a) have undergone retropubic radical prostatectomy (RRP) by a modified nerve-preserving technique (preservation of the urinary bladder neck, puboprostatic joints in prostate size > 60 cm). Preoperative and postoperative examinations for urine continence and erectile function after RRP were made in 20 patients. The proposed operative technique of nerve-preserving RRP preserves urine continence and erectile function in many cases. This improves social adaptation of the patients and extends indications for operative treatment.

[Postoperative cystitis in children]. / Posleoperatsionnyi tsistit u detei.

Operative intervention on the urinary bladder in children entails postoperative reactive cystitis. Biopsies of urinary bladder mucosa were studied morphologically. Basing on these morphological findings and clinical evidence, three leading variants of the mucosa changes were distinguished: focal squamous cell metaplasia; excess of the lymphoid tissue and lymphangiectasia; hemangiectasia. These morphological changes aggravate the course of postoperative cystitis. UHF-therapy and magnetic-laser radiation beginning postoperative day 4 and 7, respectively, reduce inflammation developing in postoperative cystitis. This indicates effectiveness of the above combined therapy which can be also used for prevention of acute inflammation episodes in postoperative period.

[Urodynamic criteria of predicting efficacy of therapy with alpha1-adrenergic blockaders in patients with benign prostatic hyperplasia]. / Urodinamicheskie kriterii prognozirovaniia éffektivnosti terapii alpha1-adrenoblokatorami u patsientov s dobrokachestvennoi giperplaziei predstatel'noi zhelezy.

AIM: As baseline urodynamic parameters do not correlate well with response to medical treatment for lower urinary tract symptoms (LUTS), this study was designed to asertain whether urodynamic parameters correlate better with response to alpha 1-adrenoblockers. METHODS: 23 men (mean age 64.6 +/- 9.3 years) with LUTS have undergone urodynamic examination prior to initiating therapy with terazosin titrated to 5 mg and followed for 2.5 months. Parameters of evaluation included IPSS symptom score, peak flow rate (Qmax), maximal detrusor pressure (Pmax), detrusor pressure at maximal flow (Pdet) and detrusor contraction duration (DCD). The correlation and predictive value of therapeutic response and baseline urodynamic parameters were assessed. RESULTS: For the entire group, IPSS decreased from 13.25 +/- 3.39 to 7.38 +/- 3.21 (44.6%), Qmax increased from 9.75 +/- 1.95 to 11.00 +/- 3.23 ml/s (21%), Pmax decreased from 109.75 +/- 35.72 to 93.88 +/- 20.91 cm. H2O (14.4%), Pdet decreased from 84.00 +/- 23.71 to 74.00 +/- 15.53 cm. H2O (16.8%), DCD increased from 127.63 +/- 53.99 to 130.13 +/- 45.41s (2.7%). There was a weak correlation between either Pmax or Pdet and therapeutic response (defined as a IPSS decrease of 40% and an increase in Qmax of 30%). There was a significant correlation with therapeutic response of DCD > 60 s (p < 0.05, r = 0.56). CONCLUSION: The pilot data suggest that DCD may be a useful urodynamic parameter to predict and optimize therapy with alpha 1-adrenoblockers.

[Use of alpha1-adrenergic blockaders in voiding disorders in women]. / Primenenie alpha1-adrenoblokatorov pri rasstroistvakh mocheispuskaniia u zhenshchin.

UNLABELLED: Alpha-adrenoblockers are commonly used to treat LUTS suggestive of benign prostatic hyperplasia in men. It is well known that they do not modify natural history of the disease but only relax the smooth muscle. Several investigations confirmed the presence of alpha 1-AR in the spinal cord, bladder neck, urethra and periurethral tissue in women (so-called female prostate). So, "prostatism-like" symptoms seem to be not gender-specific. Therefore, alpha-adrenoblockers may be used in the treatment of urinary disorders in women. 32 women (mean age 26.5 years, range 18-65) with functional BOO took a terazosin course after clinical and urodynamic examinations. The patients were divided into three groups: detrusor sphincter dyssinergia, primary bladder outlet obstruction and learned voiding dysfunction (dysfunctional voiding). Patients with urethral stricture, pelvic organ prolapse, bacteriuria were excluded. The initial dose was 1 mg/day, then it was increased to 5 mg/day. The treatment course lasted 2 months. Patients recorded the time and volume of every void three days before treatment and last three days of drug therapy. All the patients were satisfied with the results of the treatment. We noticed an increase in the maximal flow rate (55.4%), a decrease of delay time (48.9%) and nocturia (52.9%). CONCLUSIONS: Specific agents, such as alpha-adrenoblockers, in low dosage may be effective in women with urinary tract disorders in case of careful and comprehensive evaluation of functional BOO.