Introduction. The main question of the surgeon in the postoperative period is the possibilities of assessing the function of the lower urinary tract. Symptomatic assessment of urination disorders does not allow to diagnose since many symptoms are subjective and non-specific for a particular disease. Urodynamic study allows to assess the state of the urinary system and determine further tactics. Methods and materials. The study included 173 patients with morphologically verified cervical cancer IB1-IIB stages who underwent radical hysterectomy (RH). The main group consisted of 26 patients after RH type С1 using the water-jet technique. The comparison group A included 79 patients who underwent RH type С1 with the traditional technique. The comparison group B included 52 patients who accepted radical hysterectomy RH type C2. All patients underwent uroflowmetry at the preoperative and postoperative stages in order to exclude dysfunction of the lower urinary tract. Results. In a comparative study of the parameters of uroflowmetry before surgery and 2 months after surgical treatment in patients of the main group, significant differences were obtained in such parameters as the average and maximum velocity of urine flow. In control group A, statistically significant differences were obtained in such parameters as the average urine flow rate, maximum urine flow rate, urine flow time, and the volume of residual urine. In control group B, all indicators had significant differences, with the exception of the volume of urine excreted. Conclusion. Comparative results before surgery and 2 months after surgical treatment in the main group indicate the advantage of the water jet dissection technique as the most precise and nerve-sparing method.

Introduction. Among minimally invasive technologies for the treatment of stress urinary incontinence (SUI) in women, a special place is occupied by the method of paraurethral administration of bulking agents (BA). Recently, great attention has been paid to the new generation of natural biopolymers with a set of unique qualities that allow using the body's own resources to restore damaged tissues. Heterogeneous implantable gel (JSC «BIOMIR service», Russia) belongs to such BA. Objective: to evaluate the efficacy and safety of transurethral administration of BA «Sphero®GEL» LONG (SGL) in women with SUI. Materials and methods. The open prospective study included 20 women with mild or moderate SUI, aged 41-76 years, who underwent one/two transurethral implantation of SGL into the submucosal and muscular layers after clinical and urodynamic examination. Results. According to the preliminary survey, mild SUI was detected in 13 (65%) women, and moderate SUI – in 7 (35%). Initial data: visual analog scale (VAS) – 7.7 ± 2.0; quality of life (QOL) – 3.3 ± 1.2; maximum urine flow rate (Qmax) – 20.5 ± 5.3 ml/s; post-void residual urine volume (PVR) – 7.0 ± 2.1 ml; voided volume (VV) – 297.2 ± 65.6 ml; maximal cystometric capacity (MCC) – 312.1 ± 83.3 ml; maximum urethral closure pressure (MUCP) – 48.4 ±11.9 cm H2O; functional urethral length (FUL) – 20.3 ± 8.2 mm; one-hour PadTest 8.2 ± 1.9 g. Two weeks after the introduction of SGL, the satisfactory effect was detected in 17 women (85%) 6 of them (30%) were completely dry. The need for SGL additional administration occurred in 11 women (55%), which was fulfilled. There was an improvement in key parameters compared to the initial data 3 and 6 months after treatment: VAS index significant decrease by 70.1 and 63.6%; increase of MUCP by 8.9 and 7.9%; increase of FUL by 14.3 and 18.2%; statistically significant decrease of PadTest weight by 61.0 and 53.7%; improvement of QOL by 60.6 and 48.5%, respectively. There was a slight decrease in Qmax – by 11.2 – 8.3%. Changes in other indicators did not exceed normal values. When evaluating the results after 6 months in 17 patients (85%), the effect of treatment and the quality of life were assessed as satisfactory: according to PadTest results urine loss was less than 5 g. Moreover, in 11 cases (55%) urinary incontinence disappeared, so the full effect was achieved. There was no satisfactory effect in 3 women (15%), they were offered surgical treatment of SUI. Long–term results up to 12 months were followed in a group of 9 women with a good effect of SGL implantation. The dynamics of the main indicators a year after implantation was: 52.8% decrease according to VAS; 41.1% decrease according to PadTest; 48.3% of QOL improvement. SUI was also absent after a year of observation. Request for SGL re-administration was received from 3 of 8 women with unsatisfactory result, although their urine loss did not exceed 5 g per hour. No complications were observed during the SGL implantations. After the procedure urinary retention and the need for catheterization were not observed in any of patients. Allergic reactions, pain, severe hematuria, infection, tissue erosion at the injection site of SGL, as well as bladder overactivity «de novo» were not observed. Conclusion. The first experience of using the implantable heterogeneous volume-forming material SGL in women with mild and moderate SUI has confirmed the high efficiency of the technology, no worse than other samples of BA, with a high safety profile exceeding many of them. It is necessary to continue clinical research in this direction in order to implement the method into wide practice, also as part of import replacement activities.

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