smpСкорая медицинская помощьEMERGENCY MEDICAL CARE2072-6716Northwest State Medical University named after II Mechnikov10.24884/2072-6716-2019-20-1-69-79smp-329Research ArticleОБЗОРREVIEWОказание неотложной помощи при острой задержке мочеиспускания у мужчин. Современная лечебная тактика, противоречия и перспективыPROVIDING EMERGENCY CARE FOR ACUTE URINARY RETENTION IN MEN. MODERN MEDICAL TACTICS, CONTRADICTIONS AND PERSPECTIVESШпиленяЕ. С.ShpilenyaE. S.

доктор медицинских наук, профессор кафедры урологии ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И. И. Мечникова» МЗ РФ

БурлакаО. О.BurlakaO. O.

кандидат медицинских наук, заведующий отделением урологии СПб ГБУЗ «Александровская больница»

burlaka@list.ruПешехоновК. С.PeshekhonovK. S.

аспирант кафедры урологии ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И. И. Мечникова» МЗ РФ

ispesh@gmail.comШабулдовК. В.ShabuldovK. V.

студент 6-го курса ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И. П. Павлова» МЗ РФ

shabuldov.kirill@yandex.ruСеверо-Западный государственный медицинский университет им. И.И. Мечникова, Санкт-ПетербургРоссияNorth-Western State Medical University named after I. I. Mechnikov, St. PetersburgRussian FederationГородская Александровская больница, Санкт-ПетербургРоссияAlexander Municipal Hospital, St. PetersburgRussian Federation2019090420192016979Copyright © Шпиленя Е.С., Бурлака О.О., Пешехонов К.С., Шабулдов К.В., 20192019Шпиленя Е.С., Бурлака О.О., Пешехонов К.С., Шабулдов К.В.Shpilenya E.S., Burlaka O.O., Peshekhonov K.S., Shabuldov K.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://smp.spb.ru/jour/article/view/329

Острая задержка мочи — состояние, характеризующееся внезапно возникшей неспособностью осуществить мочеиспускание, которое сопровождается выраженным болевым синдромом и интенсивными позывами к мочеиспусканию. В статье обсуждаются предрасполагающие к этому патологическому состоянию факторы, роль комбинированной терапии как способ его профилактики, дана оценка современных методов дренирования нижних мочевых путей при острой задержки мочеиспускания.

Acute urinary retention is a condition characterized by a sudden inability to urinate, which is accompanied by severe pain and an intense urge to urinate. The article discusses the predisposing factors for this pathological condition, the role of combined drug therapy as a method of its prevention, assessed modern methods of drainage of the lower urinary tract during acute urinary retention.

 

острая задержка мочидоброкачественная гиперплазия предстательной железысимптомы нижних мочевых путейлечение ДГПЖacute urinary retentionbenign prostatic hyperplasialower urinary tract symptomstreatment of BPHReferencesPritchard D., Petrilla A., Hallinan S. et al. What contributes most to high health care costs? Health care spending in high resource patients // J. Manag. Care Spec. Pharm. 2016. Vol. 22, No 2. Р. 102–109.Pritchard D., Petrilla A., Hallinan S. et al. What contributes most to high health care costs? Health care spending in high resource patients // J. Manag. Care Spec. Pharm. 2016. Vol. 22, No 2. Р. 102–109.Wei J., Calhoun E., Jacobsen S. Urologic diseases in America project: benign prostatic hyperplasia // J. Urol. 2005. Vol. 173. Р. 1256–1261.Wei J., Calhoun E., Jacobsen S. Urologic diseases in America project: benign prostatic hyperplasia // J. Urol. 2005. Vol. 173. Р. 1256–1261.Naranji I., Bolgeri M. Significant upper urinary tract hematuria as a rare complication of high-pressure chronic retention of urine following decompression: A case report // J. Med. Case Rep. 2012. Vol. 6. Р. 254.Naranji I., Bolgeri M. Significant upper urinary tract hematuria as a rare complication of high-pressure chronic retention of urine following decompression: A case report // J. Med. Case Rep. 2012. Vol. 6. Р. 254.Ortman J. M., Velkoff V. A., Hogan H. An aging nation: the older population in the United States. Current Population Report. Suitland (ML): United States Census Bureau, 2014. Р. 1–28.Ortman J. M., Velkoff V. A., Hogan H. An aging nation: the older population in the United States. Current Population Report. Suitland (ML): United States Census Bureau, 2014. Р. 1–28.Emberton M., Anson K. Acute urinary retention in men: an age old problem // B. M. J. 1999. Vol. 318 (7188). Р. 921–925.Emberton M., Anson K. Acute urinary retention in men: an age old problem // B. M. J. 1999. Vol. 318 (7188). Р. 921–925.McConnell J.D., Roehrborn C. G., Bautista O. M. et al. The longterm effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia // N. Engl. J. Med. 2003. Vol. 349, No 25. P. 2387–2398.McConnell J.D., Roehrborn C. G., Bautista O. M. et al. The longterm effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia // N. Engl. J. Med. 2003. Vol. 349, No 25. P. 2387–2398.Jacobsen S. J., Jacobson D. J., Girman C. J. et al. Natural history of prostatism: risk factors for acute urinary retention // J. Urol. 1997. Vol. 158, No 2. P. 481–487.Jacobsen S. J., Jacobson D. J., Girman C. J. et al. Natural history of prostatism: risk factors for acute urinary retention // J. Urol. 1997. Vol. 158, No 2. P. 481–487.Горизловский Л. М. Избранные главы гериатрической урологии. М.: Ньюдиамед, 2000. 362 с.Gorilovskij L.M. Izbrannye glavy geriatricheskoj urologii. Moscow: Izdatel’stvo N’judiamed, 2000, 362 p. (in Russ.)Miner M. M. Primary care physician versus urologist: how does their medical management of LUTS associated with BPH differ? // Curr. Urol. Rep. 2009. Vol. 10, No 4. Р. 254–260.Miner M. M. Primary care physician versus urologist: how does their medical management of LUTS associated with BPH differ? // Curr. Urol. Rep. 2009. Vol. 10, No 4. Р. 254–260.Grabe M. et al. EAU Guidelines on Urological Infections // EAU Guidelines, edition presented atthe annual EAU Congress. Madrid, 2015.Grabe M. et al. EAU Guidelines on Urological Infections // EAU Guidelines, edition presented atthe annual EAU Congress. Madrid, 2015.Roehrborn C. G., Siami P., Barkin J. et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study // Eur. Urol. 2010. Vol. 57, No 1. P. 123–131.Roehrborn C. G., Siami P., Barkin J. et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study // Eur. Urol. 2010. Vol. 57, No 1. P. 123–131.Fitzpatrick J. M., Desgrandchamps F., Adjali K., Gomez G. L., Hong S. J., El Khalid S. et al. Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia // B. J. U. Int. 2012. Vol. 109. Р. 88–95.Fitzpatrick J. M., Desgrandchamps F., Adjali K., Gomez G. L., Hong S. J., El Khalid S. et al. Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia // B. J. U. Int. 2012. Vol. 109. Р. 88–95.Mozes B., Maor Y., Shmueli A. The competing effects of disease states on quality of life of the elderly // Quality of Life Research. 1999. Vol. 8, No 1/2. Р. 93–99.Mozes B., Maor Y., Shmueli A. The competing effects of disease states on quality of life of the elderly // Quality of Life Research. 1999. Vol. 8, No 1/2. Р. 93–99.Fourcade R. O., Lacoin F., Roupret M., Slama A., Le Fur C., Michel E., Sitbon A., Cotte F. E. Outcomes and general health-related quality of life among patients medically treated in general daily practice for lower urinary tract symptoms due to benign prostatic hyperplasia // World J. Urol. 2012. Vol. 30. Р. 419–426. 10.1007/ s00345–011–0756–2.Fourcade R. O., Lacoin F., Roupret M., Slama A., Le Fur C., Michel E., Sitbon A., Cotte F. E. Outcomes and general health-related quality of life among patients medically treated in general daily practice for lower urinary tract symptoms due to benign prostatic hyperplasia // World J. Urol. 2012. Vol. 30. Р. 419–426. 10.1007/ s00345–011–0756–2.Cindolo L., Pirozzi L., Sountoulides P. et al. Patient’s adherence on pharmacological therapy for benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS) is different: is combination therapy better than monotherapy? // B. M. C. Urol. 2015. Vol. 15. Р. 96–102.Cindolo L., Pirozzi L., Sountoulides P. et al. Patient’s adherence on pharmacological therapy for benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS) is different: is combination therapy better than monotherapy? // B. M. C. Urol. 2015. Vol. 15. Р. 96–102.Raz S., Zeigler M., Caine M. Pharmacological receptors in the prostate // Br. J. Urol. 1973. Vol. 45. Р. 663.Raz S., Zeigler M., Caine M. Pharmacological receptors in the prostate // Br. J. Urol. 1973. Vol. 45. Р. 663.Spiro L. H., Labay G., Orkin L. A. Prostatic infarction. Role in acute urinary retention // Urology. 1974. Vol. 3. Р. 345–347.Spiro L. H., Labay G., Orkin L. A. Prostatic infarction. Role in acute urinary retention // Urology. 1974. Vol. 3. Р. 345–347.Соловьев Д. А., Белый Л. Е. Острая задержка мочи при аденоме простаты: современный взгляд на проблему // Современные проблемы науки и образования. 2012. № 2.Solov’ev D.A., Belyj L. E. Ostraya zaderzhka mochi pri adenome prostaty: sovremennyj vzglyad na problemu // Sovremennye problemy nauki i obrazovanija, 2012, No 2. (in Russ.)] http://www.science-education.ru/ru/article/view?id=6007. (accessed 24.12.2018)Saboorian M. H., Gurevitch E. J., Salinger F., Roehrborn C. G., Rogers T. Morphometric analysis of pathological specimens in men undergoing prostate surgery for acute retention or symptoms of BPH only // J. Urol. 1998. Vol. 159. Р. 108 (Abst. 417).Saboorian M. H., Gurevitch E. J., Salinger F., Roehrborn C. G., Rogers T. Morphometric analysis of pathological specimens in men undergoing prostate surgery for acute retention or symptoms of BPH only // J. Urol. 1998. Vol. 159. Р. 108 (Abst. 417).Tuncel A., Uzun B., Eruyar T. et al. Do prostatic infarction, prostatic inflammation and prostate morphology play a role in acute urinary retention? // Eur. Urol. 2005. Vol. 48. Р. 277–284.Tuncel A., Uzun B., Eruyar T. et al. Do prostatic infarction, prostatic inflammation and prostate morphology play a role in acute urinary retention? // Eur. Urol. 2005. Vol. 48. Р. 277–284.Grabe M. et al. EAU Guidelines on Urological Infections // EAU Guidelines, edition presented atthe annual EAU Congress. Madrid, 2015.Grabe M. et al. EAU Guidelines on Urological Infections // EAU Guidelines, edition presented atthe annual EAU Congress. Madrid, 2015.Пушкарь Д. Ю., Раснер П. И. Опыт консервативного лечения острой задержки мочи у больных доброкачественной гиперплазией предстательной железы одновременным назначением двух уроселективных альфаадреноблокаторов — альфузозина и тамсулозина // Фарматека. 2006. № 15 (130). С. 7.Pushkar’ D. Ju., Rasner P. I. Opyt konservativnogo lecheniya ostroj zaderzhki mochi u bol’nyh dobrokachestvennoj giperplaziej predstatel’noj zhelezy odnovremennym naznacheniem dvuh uroselektivnyh al’fa-adrenoblokatorov — al’fuzozina i tamsulozina. Farmateka, 2006, No 15 (130), р. 7 (in Russ.)Sands J. P., Constantineu C. E., Govan D. E. Bladder pressure and its effect on mean arterial blood pressure // Invest Urol. 1972. Vol. 10. Р. 14+2.Sands J. P., Constantineu C. E., Govan D. E. Bladder pressure and its effect on mean arterial blood pressure // Invest Urol. 1972. Vol. 10. Р. 14+2.Hooton T. M., Bradley S. F., Cardenas D. D., Colgan R., Geerlings S. E., Rice J. C. et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: International clinical practice guidelines from the infectious diseases society of America.Hooton T. M., Bradley S. F., Cardenas D. D., Colgan R., Geerlings S. E., Rice J. C. et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: International clinical practice guidelines from the infectious diseases society of America.McConnell J.D., Bruskewitz R., Walsh P., Andriole G., Lieber M., Holtgrewe H. L. et al. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group // N. Engl. J. Med. 1998. Vol. 338. Р. 557–563.McConnell J.D., Bruskewitz R., Walsh P., Andriole G., Lieber M., Holtgrewe H. L. et al. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group // N. Engl. J. Med. 1998. Vol. 338. Р. 557–563.Wagenlehner F. M. et al. Diagnosis and management for urosepsis // Int. J. Urol. 2013. Vol. 20. Р. 963–970. 27. Roehrborn C. G., Siami P., Barkin J. et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study // Eur. Urol. 2010. Vol. 57, No 1. P. 123–131.Wagenlehner F. M. et al. Diagnosis and management for urosepsis // Int. J. Urol. 2013. Vol. 20. Р. 963–970. 27. Roehrborn C. G., Siami P., Barkin J. et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study // Eur. Urol. 2010. Vol. 57, No 1. P. 123–131.Melzer M., Welch C. Does the presence of a urinary catheter predict severe sepsis in a bacteraemic cohort? // Journal of Hospital Infection. 2017. Vol. 50, No 5. Р. 625–663.Melzer M., Welch C. Does the presence of a urinary catheter predict severe sepsis in a bacteraemic cohort? // Journal of Hospital Infection. 2017. Vol. 50, No 5. Р. 625–663.Desgrandchamps F., De La Taille A., Doublet J. D., RetenFrance Study Group The management of acute urinary retention in France: a cross-sectional survey in 2618 men with benign prostatic hyperplasia // B. J. U. International. 2006. Vol. 97, No 4. P. 727–733.Desgrandchamps F., De La Taille A., Doublet J. D., RetenFrance Study Group The management of acute urinary retention in France: a cross-sectional survey in 2618 men with benign prostatic hyperplasia // B. J. U. International. 2006. Vol. 97, No 4. P. 727–733.Вайнберг З. С. Неотложная урология. М.: Московский рабочий, 1997. 206 c.Weinberg Z. S. Neotlozhnaja urologija. Moscow: Izdatel’stvo Moskovskij rabochij, 1997, 206 p. (in Russ.)Djavan B., Chariat S., Omar M. et al. Does prolonged catheter drainage improve the chance of recovering voluntary voiding after acute urinary retention? // Eur. Urol. 1998. Vol. 33 (Suppl.). Р. 110, A437.Djavan B., Chariat S., Omar M. et al. Does prolonged catheter drainage improve the chance of recovering voluntary voiding after acute urinary retention? // Eur. Urol. 1998. Vol. 33 (Suppl.). Р. 110, A437.Mozes B., Maor Y., Shmueli A. The competing effects of disease states on quality of life of the elderly // Quality of Life Research. 1999. Vol. 8 (1/2). Р. 93–99.Mozes B., Maor Y., Shmueli A. The competing effects of disease states on quality of life of the elderly // Quality of Life Research. 1999. Vol. 8 (1/2). Р. 93–99.Ahluwalia R. S., Johal N., Kouriefs C., Kooiman G., Montgomery B. S.I., Plail R. O. The surgical risk of suprapubic catheter insertion and long-term sequelae // Ann. R. Coll. Surg. Engl. 2006. Vol. 88. Р. 210.Ahluwalia R. S., Johal N., Kouriefs C., Kooiman G., Montgomery B. S.I., Plail R. O. The surgical risk of suprapubic catheter insertion and long-term sequelae // Ann. R. Coll. Surg. Engl. 2006. Vol. 88. Р. 210.Fitzpatrick J. M., Kirby R. S. Management of acute urinary retention // B. J. U. Int. 2006. Vol. 97, Suppl. 2. Р. 16–20 [discussion: 21–22].Fitzpatrick J. M., Kirby R. S. Management of acute urinary retention // B. J. U. Int. 2006. Vol. 97, Suppl. 2. Р. 16–20 [discussion: 21–22].Abubakar S. M., Ngwobia P. A., Abdullahi A., Khalid A., Ismaila A. M. Safety and efficacy of ultrasound-guided percutaneous suprapubic cystostomy in resource-poor setting: A 7-year review // Urol. Ann. 2018. Jan-Mar. Vol. 10 (1). Р. 24–28.Abubakar S. M., Ngwobia P. A., Abdullahi A., Khalid A., Ismaila A. M. Safety and efficacy of ultrasound-guided percutaneous suprapubic cystostomy in resource-poor setting: A 7-year review // Urol. Ann. 2018. Jan-Mar. Vol. 10 (1). Р. 24–28.Ahmed S. J., Mehta A., Rimington P. Delayed bowel perforation following suprapubic catheter insertion // B. M. C. Urol. 2004. Vol. 4. Р. 16–18.Ahmed S. J., Mehta A., Rimington P. Delayed bowel perforation following suprapubic catheter insertion // B. M. C. Urol. 2004. Vol. 4. Р. 16–18.Kriegmair M. C., Mandel P., Ritter M. SUPRAPUR: Safe and convenient suprapubic catheterisation in high-risk patient // J. Urol. 2015. Vol. 68. Р. 478–483.Kriegmair M. C., Mandel P., Ritter M. SUPRAPUR: Safe and convenient suprapubic catheterisation in high-risk patient // J. Urol. 2015. Vol. 68. Р. 478–483.McLoughlin J., Jager R., Abel P. D., El Din A., Adam A., Williams G. The use of prostatic stents in patients with urinary retention who are unfit for surgery. An interim report // Br. J. Urol. 1990. Vol. 66. Р. 66–70.McLoughlin J., Jager R., Abel P. D., El Din A., Adam A., Williams G. The use of prostatic stents in patients with urinary retention who are unfit for surgery. An interim report // Br. J. Urol. 1990. Vol. 66. Р. 66–70.Lee G., Marathe S., Sabbagh S. et al. Thermo-expandable intra-prostatic stent in the treatment of acute urinary retention in elderly patients with significant co-morbidities // Int. Urol. Nephrol. 2005. Vol. 37. Р. 501–504.Lee G., Marathe S., Sabbagh S. et al. Thermo-expandable intra-prostatic stent in the treatment of acute urinary retention in elderly patients with significant co-morbidities // Int. Urol. Nephrol. 2005. Vol. 37. Р. 501–504.Fitzpatrick J. M., Desgrandchamps F., Adjali K., Gomez G. L., Hong S. J., El Khalid S. et al. Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia // B. J. U. Int. 2012. Vol. 109. Р. 88–95.Fitzpatrick J. M., Desgrandchamps F., Adjali K., Gomez G. L., Hong S. J., El Khalid S. et al. Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia // B. J. U. Int. 2012. Vol. 109. Р. 88–95.Yoon P. D., Chalasani V., Woo H. H. Systematic review and meta-analysis on management of acute urinary retention // Prostate Cancer and Prostatic Diseases. 2015. Vol. 18. Р. 297–302.Yoon P. D., Chalasani V., Woo H. H. Systematic review and meta-analysis on management of acute urinary retention // Prostate Cancer and Prostatic Diseases. 2015. Vol. 18. Р. 297–302.Dutkiewicz S., Stepien K., Witeska A. Bladder catheterization and a plasma prostate-specific antigen in patients with benign prostatic hyperplasia and complete urine retention // Mater. Med. Pol. 1995. Vol. 27. Р. 71–73.Dutkiewicz S., Stepien K., Witeska A. Bladder catheterization and a plasma prostate-specific antigen in patients with benign prostatic hyperplasia and complete urine retention // Mater. Med. Pol. 1995. Vol. 27. Р. 71–73.King T. R., Sherwood B. T., Kumar P., Parkinson R. J. The USE of PSA measurement in the setting of acute urinary retention // International Journal of Surgery. 2010. No 8. Р. 501–578.King T. R., Sherwood B. T., Kumar P., Parkinson R. J. The USE of PSA measurement in the setting of acute urinary retention // International Journal of Surgery. 2010. No 8. Р. 501–578.Mohammad E. J. The effect of acute urinary retention on the accuracy of serum prostate-specific antigen level measurements // The Iraqi Postgraduate Medical Journal. 2012. Vol. 11 (1).Mohammad E. J. The effect of acute urinary retention on the accuracy of serum prostate-specific antigen level measurements // The Iraqi Postgraduate Medical Journal. 2012. Vol. 11 (1).Chen J. S., Chang C. H., Yang W. H., Kao Y. H. Acute urinary retention increases the risk of complications after transurethral resection of the prostate: a population-based study // B. J. U. Int. 2012. Vol. 110, Nо 11, Pt C. P. 896–901.Chen J. S., Chang C. H., Yang W. H., Kao Y. H. Acute urinary retention increases the risk of complications after transurethral resection of the prostate: a population-based study // B. J. U. Int. 2012. Vol. 110, Nо 11, Pt C. P. 896–901.

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