Epidemiological aspects of overactive bladder and urge urinary incontinence

The review article presents data on the efficacy and tolerability of intravesical injections of botulinum toxin in patients with overactive bladder. The pharmacological bases of the use of botulinum therapy in this category of patients are described in detail. Data on the history of the use of botulinum toxin for medical purposes are presented. Experience to date shows that intravesical botulinum toxin injections are highly effective and well tolerated in patients with refractory overactive bladder. Botulinum therapy is included in domestic and foreign clinical guidelines as a 3rd line treatment for idiopathic and neurogenic overactive bladder. Indications for its implementation are the inefficiency and/or poor tolerability of oral pharmacotherapy. It is noted that the only botulinum toxin recommended for use in clinical practice for the treatment of overactive bladder is onabotulinumtoxin A (Botox). The results of clinical studies are presented, showing that the effectiveness and safety of botulinum therapy do not decrease over time.

Long-term botulinum therapy for overactive bladder: myths and reality

Kuzmin¹,

Slesarevskaya²,

Amdiy³

et al. 2022

Personalized approach to pharmacotherapy of overactive bladder

Kuzmin

2023

The article provides an overview of modern approaches to pharmacotherapy of overactive bladder. It has been shown that the choice of drug therapy for overactive bladder should be made taking into account the pathophysiological mechanisms of the development of the disease, the characteristics of its clinical course, as well as the potential risks of developing side effects of treatment. A pathogenetic rationale for the choice of treatment tactics for different categories of patients is presented, including those with a hypersensitive bladder, bladder outlet obstruction, neurological and geriatric patients. The pharmacological properties of the 3-adrenergic receptor agonist mirabegron are described, which provide high efficacy and a favorable safety profile in the treatment of patients with overactive bladder. The practical issues of prescribing mirabegron in various clinical situations are considered.

Persistent dysuria in women: etiological diagnostics and treatment

Slesarevskaya

Николаевна²,

Ignashov

et al. 2021

INTRODUCTION:Dysuria is a painful urination combined with its frequency and/or difficulty. Dysuria is observed in many urological diseases and is one of the most common reasons for treatment for urological cause. AIM:The aim of the study is to identify the etiological factors of dysuria in women and to evaluate a personalized approach to their treatment. MATERIALS AND METHODS:We analyzed the data of 368 women with chronical cystitis. The inclusion criteria for the study were the presence of dysuria (painful and frequent urination more than 8 times a day with or without difficulty), the prescription of urination disorders over one year old and age 18 and over. All patients underwent a comprehensive urological examination to identify the causes of urinary disorders. RESULTS:The Bacterial cystitis was confirmed only in 78 (21.2%) patients among all 368 women. In the remaining 290 (78.8%) patients, the causes of persistent dysuria were other diseases: bladder leukoplakia in 154 (41.8%), bladder pain syndrome/interstitial cystitis in 38 (10.3%), viral cystitis in 34 (9.3%), paraurethral formations in 29 (7.9%), neurogenic urinary dysfunction bladder in 25 (6.8%), urethral pain syndrome in 5 (1.4%) patients. Dysuria was also caused by postradiation cystitis (2 patients), secondary stones in the urinary bladder (2 patients), and one patient had extragenital endometriosis. CONCLUSIONS:The variety of reasons for the development of persistent dysuria in women requires careful examination of patients. Treatment should be carried out only after accurate verification of the diagnosis.