urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2020-8-4-62-71urovest-390Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESТрансвертебральная магнитная нейромодуляция как метод лечения гиперактивности мочевого пузыря: 6 месяцев наблюденияTransvertebral magnetic neuromodulation for the treatment of overactive bladder: 6 months follow-uphttps://orcid.org/0000-0003-4884-6884КовалевГ. В.KovalevG V.

Ковалев Глеб Валерьевич — врач-уролог Клиники высоких медицинских технологий им. Н.И. Пирогова СПбГУ.199034, Санкт-Петербург, Университетская наб., д. 7-9.тел.: +7 (911) 199-72-75

Gleb V. Kovalev — M.D.; Urologist, N.I. Pirogov Clinic of Advanced Medical Technologies; St. Petersburg State University.199034, St. Petersburg, 7-9 Universitetskaya qy.tel. +7 (911) 199-72-75

kovalev2207@gmail.comhttps://orcid.org/0000-0003-0489-3451ШкарупаД. Д.ShkarupaD. D.

Шкарупа Дмитрий Дмитриевич — доктор медицинских наук; заместитель директора по организации медицинской помощи, Клиники высоких медицинских технологий им. Н.И. Пирогова СПбГУ, руководитель Северо-Западного центра пельвиоперинологии г. Санкт-Петербург.199034, Санкт-Петербург, Университетская наб., д. 7-9.

Dmitry D. Shkarupa — M.D., Dr.Sc.(M); Deputy CEO, N.I. Pirogov Clinic of Advanced Medical Technologies; St. Petersburg State University; Head, Northwest Pelvioperinology Centre.199034, St. Petersburg, 7-9 Universitetskaya qy.

shkarupa.dmitry@mail.ruhttps://orcid.org/0000-0001-5189-4639КубинН. Д.KubinN. D.

Кубин Никита Дмитриевич — доктор медицинских наук; врач-уролог Клиники высоких медицинских технологий им. Н.И. Пирогова СПбГУ.199034, Санкт-Петербург, Университетская наб., д. 7-9.

Nikita D. Kubin — M.D., Dr.Sc.(M); Deputy CEO, N.I. Pirogov Clinic of Advanced Medical Technologies; St. Petersburg State University.199034, St. Petersburg, 7-9 Universitetskaya qy.

nikitakubin@gmail.comhttps://orcid.org/0000-0002-8763-6188ЗайцеваА. О.ZaitsevaA. O.

Зайцева Анастасия Олеговна — врач-уролог Клиники высоких медицинских технологий им. Н.И. Пирогова СПбГУ г. Санкт-Петербург.199034, Санкт-Петербург, Университетская наб., д. 7-9.

Anastasiya O. Zaytseva — M.D.; Urologist, N.I. Pirogov Clinic of Advanced Medical Technologies; St. Petersburg State University.199034, St. Petersburg, 7-9 Universitetskaya qy.

zaytseva-anast@mail.ruhttps://orcid.org/0000-0001-7526-1553БородулинаИ. В.BorodulinaI. V.

Бородулина Ирина Владимировна — кандидат медицинских наук; врач-невролог РМАНПО Минздрава России.125993, Москва, ул. Баррикадная, д. 2/1, стр. 1.

Irina V. Borodulina — M.D., Cand.Sc.(M); Neurologist, Russian Medical Academy of Continuous Postgraduate Education.125993, Moscow, 2/1 bld.1 Barrikadnaya st.

irina.borodulina@gmail.comhttps://orcid.org/0000-0002-7324-9021МусиенкоП. Е.MusienkoP. E.

Мусиенко Павел Евгеньевич — доктор медицинских наук, профессор; заведюующий лабораторией нейропротезов Института трансляционной биомедицины СПбГУ; заведюующий лабораторией клинической нейрофизиологии и нейрореабилитаци-онных технологий РНЦРХТ им. ак. А.М. Гранова Минздрава России; ведущий научный сотрудник лаборатории физиологии движений Института физиологии им. И.П. Павлова РАН г. Санкт-Петербург.199034, Санкт-Петербург, Университетская наб., д. 7-9; 197758, Санкт-Петербург, п. Песочный, ул. Ленинградская, д. 70; 199034, Санкт-Петербург, наб. Макарова, д.6.

Pavel E. Musienko — M.D., Dr.Sc.(M); Full Prof.; Head, Laboratory of Neuroprostheses, Institute of Translational Biomedicine, St. Petersburg State University; Head, Laboratory of Clinical Neurophysiology and Neurorehabitation Technologies, Academician A.M. Granov Russian Scientific Centre for Radiology and Surgical Technologies; Leading Researcher, Laboratory of Motion Physiology, I.P. Pavlov Institute of Physiology Russian Academy of Sciences.Saint Petersburg State University 199034, St. Petersburg, 7-9 Universitetskaya qy.; 197758, St. Petersburg, Pesochny sett., 70. Leningradskaya st.; 199034, St. Petersburg, 6 Makarova qy.

pol-spb@mail.ruСанкт-Петербургский государственный университетРоссияSaint Petersburg State UniversityRussian FederationРоссийская медицинская академия непрерывного последипломного образования» Минздрава РоссииРоссияRussian Medical Academy of Continuous Postgraduate EducationRussian FederationСанкт-Петербургский государственный университет; Российский научный центр радиологии и хирургических технологий имени академика А.М. Гранова Минздрава России; Институт физиологии им. И.П. Павлова Российской академии наукРоссияSaint Petersburg State University; Academician A.M. Granov Russian Scientific Center for Radiology and Surgical Technologies; I.P. Pavlov Institute of Physiology Russian Academy of SciencesRussian Federation202023122020846271Copyright © Ковалев Г.В., Шкарупа Д.Д., Кубин Н.Д., Зайцева А.О., Бородулина И.В., Мусиенко П.Е., 20202020Ковалев Г.В., Шкарупа Д.Д., Кубин Н.Д., Зайцева А.О., Бородулина И.В., Мусиенко П.Е.Kovalev G.V., Shkarupa D.D., Kubin N.D., Zaitseva A.O., Borodulina I.V., Musienko P.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/390

Ведение. Наиболее распространённым видом дисфункции нижних мочевыводящих путей является гиперактивный мочевой пузырь (ГАМП). На сегодняшний день существует потребность в поиске новых эффективных методов лечения данного заболевания.Цель исследования. Оценить эффективность трансвертебральной магнитной нейромодуляции (ТМН) поясничного отдела позвоночника у пациентов с ГАМП.Материалы и методы. В исследование были включены 26 пациентов. Курс лечения составил 15 процедур (3 раза в неделю 5 недель). До и после лечения на сроках 1, 3 и 6 месяцев проводилась оценка субъективных жалоб посредством опросников ICIQ-SF и OAB-q SF. Оценивались объективные показатели посредством уродинамиче-ских исследований до и спустя 6 месяцев после лечения.Результаты. Достигнуто значимое улучшение субъективного состояния пациентов на всех этапах наблюдения. Наибольшее влияние трансвертебральная магнитная нейромодуляция оказала на такие уродинамические параметры, как первое ощущение наполнения, первое ощущение позыва, сила позыва, максимальная цистометрическая ёмкость. Паттерны фазовой гиперактивности регрессировали у 60,8% пациентов после лечения и терминальной гиперактивности — у 41,7 % пациентов.Выводы. В исследовании получен значимый терапевтический эффект ТМН у пациентов с ГАМП. Необходимы дальнейшие крупные плацебо-контролируемые исследования для создания универсальных эффективных протоколов лечения дисфункций нижних мочевыводящих путей.

Introduction

Introduction. The most common type of lower urinary tract dysfunction is an overactive bladder (OAB). Today there is a need to search for new effective methods of treating this disease.Purpose of the study. To evaluate the effectiveness of transvertebral magnetic neuromodulation (TMN) of the lumbar spine in patients with OAB.Materials and methods. 26 patients were enrolled in the clinical study. The treatment course consisted of 15 procedures (3 times a week for 5 weeks). Before and after treatment at 1, 3 and 6 months, complaints were assessed using the ICIQ-SF and OAB-q SF questionnaires. Objective parameters were assessed by urodynamic tests before and 6 months after treatment.Results. We observed a significant improvement in patients subjective clinical status at all points of assessment. Transvertebral magnetic neuromodulation had the greatest influence on such urodynamic parameters as the first sensation, the first desire, strong desire, maximum cystometric capacity. Patterns of phase hyperactivity were absent in 60.8% of patients after treatment and terminal hyperactivity in 41.7% of patients.Conclusions. This small study observed a significant therapeutic effect of TMN in patients with OAB. Further large placebo-controlled trials are needed to develop universal effective protocols for lower urinary tract dysfunction treatment.

 

 

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The authors declare that there are no conflicts of interest present.