Lyulko A. Optimization of surgical treatment of women with pelvic prolapse and urinary incontinence.

The dissertation is devoted to the improvement of the treatment efficiency of patients with prolapse of the pelvic organs and associated urinary incontinence, by fixing the ligament apparatus of the pelvis and simultaneous anatomical correction of the bladder neck. Clinical, functional, urodynamic, X-ray, echographic, instrumental features of the obtained results of the research are studied. The structure and frequency of concomitant pathology and factors that aggravate the pelvic prolapse are presented. The choice of the method of patient's treatment with prolapse of the pelvic organs and associated urinary incontinence is scientifically substantiated, depending on the pathogenetic variant of its development and the degree of prolapse of the pelvic organs. A method of treatment of prolapse of the pelvic organs and urinary incontinence in women is improved by strengthening the ligament apparatus of the pelvis, taking into account anatomical features and degree of prolapse, with anatomical correction of the bladder neck. It is established that the most common complaint in patients with pelvic organs prolapse and associated urinary incontinence are: urinary incontinence with physical stress: coughing, sneezing, running, jumping, walking and at rest. It is shown that prolapse of pelvic organs and incontinence affect both the mental and physical health of a womаn, significantly reducing the quality of life It is shown that these women have changes of interposition in the location of the pelvic organs (ultrasound diagnostics), with cystoscopy, the presence of deformation of the bladder and its neck. The presented cystographic data of the study revealed urethral enlargement and bladder dilation (anatomical disorders), and functional (uroflowmetry) - the presence of functional disoders of the urinary excretory system in women with pelvic organs prolapse and associated urinary incontinence, which had a normal, obstructive, obstructive-interrupted type of urination. A method of surgical simultaneous correction of pelvic organs prolapse and associated urinary incontinence is proposed. Proposed patent for utility model of operative intervention in women with this pathology showed a significantly high persistent effectiveness, simultaneously low percentage of relapses.