I.I. MUSIN, I.B. FATKULLINA, G.Kh. GAZIZOVA, E.M. POPOVA, A.R. MOLOKANOVA

Bashkir State Medical University, Ufa

 Contact details:

Musin I.I. ― PhD (medicine), Associate Professor of the Department of Obstetrics and Gynaecology

Address: 3 Lenin Str., Ufa, Russian Federation, 450008, e-mail: ilnur-musin@yandex.ru

Objective ― to assess the microcirculation status of anterior vaginal wall and the exercise complex to strengthen the pelvic floor muscles using biofeedback to prevent erosion after mesh implants setting.

Material and methods. Research was carried out in two stages. At the first stage, retrospective analysis of post-operative complications were studied in 198 cases of patients with incontinence. At the second stage, 65 patients were divided into two groups: 35 patients of reproductive age and 30 patients in menopause. The patients underwent laser Doppler flowmetry to assess microcirculation in vagina. To assess the microcirculation channel, we used laser analyzer of blood microcirculation LAKK-01 («Lazma» research and production company, Russia).

Results. At the first stage, mesh prosthesis erosion was found in 12 patients, all in menopause. That is why, it was decided to compare microcirculation in women of reproductive age (35 patients, group 1) and patients in menopause (30 patients, group 2). When registering LDF in the first group, it was found that M ― 19.56±0.58 pf. units, σ ― 3.32±0.32 pf. units, Kv ― 16.98%. In the second group M ― 10.89±0.6 pf. units, σ ― 3.51±0.56 pf. units, Kv ― 15.48%. From this it follows that in patients in menopause LDF is lower than in women of reproductive age. We proposed a set of exercises to strengthen the pelvic floor muscles with biofeedback, which led to an improvement of microcirculation in vagina ― М ― 12.68±0.4 pf. units, σ ― 3.53±0.56 pf. units, Kv ― 15.44%.

Conclusions. Before installing mesh implants, we offer all patients to measure LDF on the anterior wall of vagina. If indices are below normal, we recommend a set of exercises based on biological feedback to prevent mesh prosthesis erosion. After three months after operative treatment, LDF on the anterior wall of the vagina is measured.

Key words: mesh prostheses, laser Doppler flowmetry, biofeedback.

(For citation: Musin I.I., Fatkullina I.B., Gazizova G.Kh., Popova E.M., Molokanova A.R. Using laser Doppler flowmetry and biofeedback to prevent erosion of mesh prostheses. Practical medicine. 2019. Vol. 17, № 4, P. 88-91)

REFERENCES

1. Yashchuk A.G., Musin I.I., Naftulovich R.A. et al. Comparative effectiveness of certain types of biological materials for various defects of the pelvic floor. Vestnik sovremennoy klinicheskoy meditsiny, 2018, pp. 82-88 (in Russ.).
2. Pavlov V.N., Zagitov A.A., Izmaylov A.A. et al. Rehabilitation of urological patients. Byulleten’ sibirskoy meditsiny, 2012, pp. 153-156 (in Russ.).
3. Nechiporenko A.N., Strotskiy A.V. Implant-associated complications after surgical correction of genital prolapse and urinary incontinence with synthetic prostheses. Mezhdunarodnye obzory: klinicheskaya praktika i zdorov’e, 2018, pp. 65-73 (in Russ.).
4. Yashchuk A.G., Musin I.I., Popova E.M. et al. Surgical treatment of stress urinary incontinence in women using collagen material. Eksperimental’naya i klinicheskaya urologiya, 2015, pp. 124-126 (in Russ.).
5. Buyanova S.N., Popov A.A., Shchukina N.A. et al. Long-term results of median colporaphia and mesh-vaginopexy. Rossiyskiy vestnik akushera-ginekologa, 2017, pp. 78-82 (in Russ.).
6. Nechiporenko A.S. Radiation diagnostic methods for implant-associated complications of surgical treatment of genital prolapse and stress urinary incontinence in women. Zhurnal Grodnenskogo gosudarstvennogo meditsinskogo universiteta, 2018, pp. 567-570 (in Russ.).
7. Shepherd A.P., Öberg P.Å. (Eds.). Laser-Doppler blood flowmetry (vol. 107), Springer Science & Business Media, 2013.
8. Barkhatov I.V. The use of laser Doppler flowmetry to assess violations of the human blood microcirculation system. Kazanskiy meditsinskiy zhurnal, 2014, 95 (1), pp. 63-9 (in Russ.).
9. Yashchuk A.G., Rakhmatullina I.R., Musin I.I., Kamalova K.A., Yashchuk K.N. Pelvic floor muscle training according to the method of biological feedback in primiparous women after vaginal delivery. Meditsinskiy vestnik Bashkortostana, 2018, 13 (4), pp. 17-22 (in Russ.).