The dissertation is devoted to improving the visualization of the paraurethral glands in women with options for their localization and bringing their functional significance. The work was carried out in the State Institution "Institute of Urology of the National Academy of Medical Sciences of Ukraine", Department of Reconstructive Urology and Latest Technologies. Execution period 2017-2020.
The basis of the work was 94 conventionally healthy women of reproductive age, who were selected from 147 women according to the data of a standard survey, in accordance with the criteria of the study, who, for various reasons, applied to the consultative polyclinic of the basic institution. To achieve the goal, a wide range of standard and special examination methods were involved. The key ones were MRI, ultrasound with dopplerography, biochemical, for the study of glandular secretions and a complex of sociological studies using well-known questionnaires, schemes, as well as their own compiled questionnaires.
The author was the method for identifying the paraurethral glands, taking into account their anatomical location and the method of video stimulation during ultrasonographic examination. Based on the results of hardware methods, proven visualization of isoechoic, homogeneous structures in the form of an accumulation of glandular tissue, convex florms with clear contours, which are presented as paraurethral glands. Identified variants of localization: in 72.2% of cases the anterior type, 21.3% - posterior, in 7.5% diffuse. The difference between the secretion of the glands and urine is objectivized. Based on the multifaceted analyzes of the values of the main parameters of the ultrasound scan, their reference values have been established for the first time: the volume of the paraurethral glands - 2.31 - 2.47 cm3; diameter of the paraurethral artery - 0.69 - 1.23 mm; blood flow velocity in the vessels of the paraurethral glands - 9.0 - 9.37 cm3 / s; vascular resistance index - 0.82 - 0.85 cm; pulsation index - 1.59 - 1.67 cm. The traced feature between the localization of the paraurethral glands and the nuances of sexual relations in the form of their later onset, a greater number of sexual partners and the frequency of sexual relations with the posterior variant of localization. In addition, it manifested itself in twice as many highly active erogenous zones. Even in cases of sexual comfort, the average score for achieving satisfaction and orgasm is significantly lower in women with a posterior type of location of the paraurethral glands. Underestimation by sexual partners of the use of erogenous zones (up to 4-5) and their non-coincidence with strongly active ones considers most women to be the cause of dissatisfaction with their sexual life.
The men surveyed include the absence of statisfaction, a low level of arousal in the form of insufficient lubrication, and their partners more often had a posterior type of localization of the glands.
It was revealed that in cases of manifestations of sexual dysfunctions: the minimized level of alkaline phosphatase, in the absence of it in women who are in the zone of sexual comfort (360±0.05 nm/chl), at the same time, there is a decrease in the activity of neutral α-glucosidase (867± 52 versus 1242 ± 64), the appearance of a protein with an average concentration of 1.03 ± 0.05 g/l, as well as with a twice higher level of prostate-specific antigen in the blood (0.41 ng/ml ).
In addition, due to the high enzymatic activity in the secret of neutral α-glucosidase and γ-glutamyltranspeptidase (in the absence of them in urine), the vaginal neutral-alkaline environment is supported. It is essential that they release a secret in a volume of 2-2.5 cm3, which contributes to lubrication.
