Shostak M. Complex opiate-electropulse treatment of patients with overactive bladder.

The thesis is dedicated to investigation of efficiency and safety of peripheral opioid receptor agonist dalargin in treatment of patients with overactive bladder (OAB) as monotherapy and in combination with the author's technique of pelvic floor electrostimulation. While studying the dynamics of objective and subjective indicators for 12 weeks of treatment with dalargin it is noted a reliable reduction of reflex excitability, involuntary detrusor contractions and bladder sensitivity, considerable growth of compliance, detrusor pressure normalization, restoration of functional and cystometric bladder capacity, descent of clinical symptoms, coping-behavior, normalization of urination' rhythm and effectiveness, essential improvement of patients' quality of life. Combined use of a leucine-enkefalin analog dalargin and author's technique of pelvic floor electrostimulation shows summation and potentiation of mutual effects with equal vector - antinociceptive, antispastic, vasomotor and neurotropic, which leads to effective reduction of pathologic excitability and increased sensitivity, elimination of clinical and urodynamic OAB symptoms. It is established a cause-effect relationship of effectiveness of dalargin treatment (monotherapy and complex opiate-electropulse therapy) due to OAB clinical course and sex of patients. Based on opioid effectiveness findings, a principal clinical differential algorithm of diagnostic and treatment for patients with OAB was elaborated