Digital solutions in choosing the volume of surgical treatment in postmenopausal women with stress urinary incontinence

Background. Stress urinary incontinence in postmenopausal women is one of the urgent problems of modern urogynecology. According to WHO, about 160 million women world wide suffer from this pathology. The existing modern methods of urinary incontinence correction are aimed at improving the support of the vesico-urethral junction and correcting insufficient closure of the urethra. However, currently there are no tools to determine which of the options for the operation to perform in each specific case. The purpose of the study. To develop software for choosing a method of surgical treatment of stress urinary incontinence in combination with cystocele in postmenopausal women based on a comprehensive preoperative examination. Material and methods. A prospective randomized study was conducted, which included 80 postmenopausal women with stress urinary incontinence in combination with cystocele, who were admitted to the gynecological clinic of the Federal State Budgetary Institution Research Institute of OMM for surgical treatment. All patients, after signing a voluntary in formed consent to participate in the study and conducting a comprehensive preoperative   examination using a random number generator, were randomized into two groups. The first group (group A) consisted of 40 women who received surgical treatment in the amount of anterior colporrhaphy in combination with urethropexy with a synthetic loop; the second group (group B) included 40 patients who underwent surgical treatment by the method of paraurethral injection of a volume-forming gel in combination with anterior colporrhaphy. Static data processing was carried out using the application package Excel, SPP Statistics 22.0, Statistica for Windows 10 (TIBCO Software Inc., Palo Alto, CA, USA).For scores with a normal distribution, the mean and standard deviation were reported. Testing of statistical hypotheses about the absence of intergroup differences for quantitative traits with a normal distribution was carried out using Student’s t-test. For dichotomous indicators, the relative value as a percentage were indicated, and the chi-square test was used to test statistical hypotheses. Research results. The developed formulas and the created software allow the clinician to choose the method of effective surgical treatment of SUI in combination with cystocele in postmenopausal women, thereby implementing a personalized approach to choosing the   method of surgical treatment. Conclusion. Thanks to the developed formulas and the creation of software that could help the clinician to choose a method for effective surgical treatment of SUI in combination with cystocele in postmenopausal women, a personalized approach to choosing a method of surgical treatment has been optimized.

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