medigraphic.com
Organo Oficial de la Sociedad Mexicana de Urología

2017, Number 5

Next >>

Rev Mex Urol 2017; 77 (5)

Clinical and urodynamic evaluation of diabetic bladder dysfunction

Viveros-Elías JM, García-González A, Gaxiola-Robles R, Gutiérrez-González A

Language: Spanish
References: 17
Page: 339-345
PDF size: 322.26 Kb.


ABSTRACT

Background: Diabetic bladder dysfunction is one of the most common late complications of diabetes, with a prevalence of 20-80%. It affects quality of life, causing retention, infections, urinary incontinence, and even kidney failure. Diabetic bladder dysfunction is characterized by reduced bladder sensitivity, detrusor overactivity and hypocontractility, and incomplete bladder voiding.
Objetive:Materials and Methods: A descriptive, cross-sectional study was conducted on patients diagnosed with diabetes mellitus of 5-year progression that were analyzed through the AUA Score questionnaire, uroflowmetry (residual urine measurement), and urodynamic study. Descriptive statistics and bivariate analysis (Mann-Whitney U test, Student’s t test, and χ2 test) were employed, with a p ‹ 0.05.
Results: Forty-one patients were registered, 63% of whom had the following urodynamic findings of diabetic bladder dysfunction: reduced sensitivity (27%), detrusor overactivity (42%), detrusor hypocontractility (38%), and incomplete voiding (73%). The AUA Score, Qmax in free uroflowmetry, and Bladder Voiding Efficiency showed no correlation with the specific urodynamic findings.
Conclusions: Diabetic bladder dysfunction is more frequent than is commonly thought. Invasive urodynamic studies continue to be the basis of diagnosing bladder dysfunction as a complication of diabetes mellitus.


REFERENCES

  1. Wild S, Roglic G, Green A, et.al. Global prevalence of diabetes. Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-1053.

  2. Instituto Nacional de Salud Pública. Encuesta Nacional de Salud y Nutrición 2012. México. 2012;108-122.

  3. Rebolledo FA. Neuropatía diabética. Aspectos prácticos, diagnóstico, terpéuticos y medidas profilácticas. 2ª ed. México: Editorial Alfil, 2008;XIII-XXVII.

  4. Jung HS. Clinical implications of glucose variability: chronic complications of diabetes. Endocrinol Metab. 2015;30(2):167-74.

  5. Boulton A, Vinik A, Arezzo J, et al. Diabetic neuropathies. Diabetes Care. 2005;28 (4):956-962.

  6. Jensen D, Klevmark V. Systemic illnesses (diabetes mellitus, sarcoidosis, alcoholism, and porphyrias). Diabetes mellitus. Corcos J, Schick E. Textbook of Neurogenic Bladder. 2ª ed. Londres: Informa Healthcare, 2008;229-233.

  7. Sheng C, Huai T, Hong Y. Are lower urinary tract symptoms in women with Type 2 Diabetes affected by glycemic control?. J Urol. 2013;189(4S):e649

  8. Gomez CS, Kanagarajah P, Gousse A. Bladder dysfunction in patients with diabetes. Curr Urol Rep 2011;(12):419- 426.

  9. Yamaguchi C, Sakakibara R, Uchiyama T, et al. Bladder sensation in peripheral nerve lesions. Neurourol Urodyn. 2006;25:763-9.

  10. Abrams P, Cardozo L, Fall M, Griffiths D, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78.

  11. Kaplan S, Te A, Blaivas JG, et al. Urodynamic findings in patients with diabetic cystopathy. J Urol. 1995;153(2):342- 344.

  12. Kaplan S. Update on the American Urological Association Guidelines for the Treatment of Benign Prostatic Hyperplasia. Rev Urol. 2006;8(suppl 4):S10-S17.

  13. Abrams P. Bladder Outlet Obstruction Index, Bladder Contractility Index and Bladder Voiding Efficiency: three simple indices to define bladder voiding function. BJU Int 1999;84(1):14-15.

  14. Shäfer W, Abrams P, Liao L, et al. Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 2002;21(3):261-74.

  15. Daneshgari F, Guiming L, Lori Birder, et al. Diabetic Bladder Dysfunction: Current Translational Knowledge. J Urol 2009;182;S18-S-26.

  16. Groutz A, Blaivas J, Fait G, et al. The significance of the American Urological Association symptom index score in the evaluation of women with bladder outlet obstruction. J Urol. 2000;163(1):207-11.

  17. Lee WC, Wu CC, Wu HP, Tai TY. Lower urinary tract symptoms and uroflowmetry in women with type 2 diabetes mellitus with and without bladder dysfunction. Urology. 2007;69(4):685-90.




2020     |     www.medigraphic.com