Urinary Incontinence in Women with Pelvic Floor Dysfunction in Perimenopause and Postmenopause
Relevance. In recent decades, there has been an increase in the incidence of genital prolapse and urinary incontinence, which adversely affect the quality of women’s life in all age groups. The various types of urinary incontinence are often symptoms of pelvic floor dysfunction. Materials and Methods. Our study involved 299 patients with II-IV stage of genital prolapse (POP-Q classification system). These patients were divided into 4 groups according to complaints, presence or absence of dysfunction of adjacent organs. In addition to the standard research methods: keep of the urination diary, examination on the gynecological chair - a complex urodynamic study was performed in all patients. A diagnosis of urinary incontinence and its type were established based on this study and patient’s complaints. Results. The survey and questionnaire showed that different types of urinary incontinence were noted in 2/3 of the examined patients with genital prolapse (203 patients, 67.89%). In 93 patients (45.8%) in groups 2 and 4 the symptoms both ovveractive bladder and stress urinary incontinence were detected. However, in 65 (69.8%) of them urgent symptoms were dominated, and in 28 (30.2%) patients had symptoms of urinary incontinence after stress. Thus, stress urinary incontinence was observed in 66 (32.5%) patients, and isolated оveractive bladder in 44 patients (21.6%). Conclusion. As our studies showed, the main risk factors of all types of pelvic floor dysfunction are vaginal birth, obesity, the duration of postmenopause 6 years and more, vulvovaginal atrophy and extragenital diseases. The undifferentiated connective tissue dysplasia and estrogen deficiency in peri- and postmenopause are very significant for the development of this pathology.