Features of pathogenetic therapy and prevention of recurrent lower urinary tract infections in postmenopausal women

Background. The incidence of urogenital disorders in women aged 55-70 years reaches 30-75%. This is a complex of vaginal and urinary symptoms, the development of which is a complication of age-related processes in estrogen-dependent tissues and structures of the lower urinary tract and reproductive tract.
Objective. To study the effectiveness of the dietary supplement, containing a complex of natural plant substances – D-mannose, cranberry type A proanthocyanidins and vitamin C, in patients with recurrent lower urinary tract infections during the postmenopausal period.
Materials and methods. The study included 90 postmenopausal patients with recurrent urinary tract infection. The main group consisted of 46 patients, the control group – 44 patients (average age 59.3 ± 5.3 years). Patients of the main group were prescribed antimicrobial therapy for exacerbations (fosfomycin trometamol in a dose of 3 g once) + dietary supplement Cystenium II, containing a complex of natural plant substances, which was used 1 tablet 2 times a day with meals for 3 months. Patients in the control group received standard antimicrobial therapy in case of exacerbation of urinary tract infection. The results were assessed 1 month after the start of therapy and 6 months later.
Results. During the study, all patients of the main group (46 women), who used the Cystenium II dietary supplement as part of treatment, together with antimicrobial therapy during an exacerbation of infection, noted a significant improvement in both general well-being and local symptoms not only at visits 1 month after the start of taking the drug, but also during the entire observation period after 6 months. As a result of the active anti-inflammatory, protective action, and the presence of vascular effects of the components of the dietary supplement, not only the general condition of the patients improved, according to LDF data, positive dynamics were noted at the level of microcirculation of the tissues of the bladder wall and urethra and, as shown by ultrasound Dopplerography, venous congestion in the pelvic organs and paraurethral plexus is reduced. The use of the dietary supplement allowed not only to significantly reduce the rate of asymptomatic bacteriuria among women in the main group, but also the number of relapses of cystitis over 6 months of observation from the start of therapy. An important predisposing factor in the development of recurrent urinary tract infection in postmenopausal women is the state of the hormonal background, which entails metabolic, local immune changes, and disorder of pelvic hemodynamics as a whole. Adequate blood supply, including venous, is also one of the main prerequisites for the normal functional activity of the mucous membrane of the urogenital area and bladder. The active components included in the dietary supplement not only help improve the hemodynamics of the bladder and urethra, but also have a protective, anti-inflammatory effect, as evidenced by a 4-fold decrease in the number of urinary tract infection relapses in patients of the main group over 6 months of observation.
Conclusion. The results obtained indicate the high therapeutic effectiveness of the dietary supplement, containing a complex of natural plant substances, both for complex therapy and for the prevention of relapses of lower urinary tract infections in patients, including during the postmenopausal period.

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