Investigation of Urodynamic Characteristics and Bladder Sensory Function in the Early Stages of Diabetic Bladder Dysfunction in Women With Type 2 Diabetes
Received 5 April 2008 published online 14 November 2008.
Refers to article:
Diabetic Cystopathy—What Does it Mean?
, 13 November 2008
Jeanette S. Brown
The Journal of Urology
January 2009 (Vol. 181, Issue 1, Pages 13-14) Full Text |
Full-Text PDF (52 KB)
GRC-6211, a New Oral Specific TRPV1 Antagonist, Decreases Bladder Overactivity and Noxious Bladder Input in Cystitis Animal Models
, 17 November 2008
Ana Charrua, Célia D. Cruz, Shridhar Narayanan, Laxmikant Gharat, Srinivas Gullapalli, Francisco Cruz, António Avelino
The Journal of Urology
January 2009 (Vol. 181, Issue 1, Pages 379-386) Abstract |
Full Text |
Full-Text PDF (873 KB)
Purpose
We studied urodynamic characteristics and bladder sensory function in the early stages of diabetic bladder dysfunction in diabetic women.
Materials and Methods
A total of 86 consecutive type 2 diabetic women with minimal confounders of voiding dysfunction followed at a diabetes clinic were prospectively enrolled and subjected to urodynamic studies. The sensory response of Aδ and C fibers of the bladder was measured by intravesical current perception threshold testing at frequencies of 250 and 5 Hz, respectively.
Results
Of these 86 women 30 (34.9%) were classified as having detrusor underactivity, 12 (14.0%) presented signs of detrusor overactivity, 11 (12.8%) were referred to as having bladder outlet obstruction and 33 (38.4%) showed normal detrusor function on urodynamics. The normal detrusor function group was the reference group. The detrusor underactivity group showed impaired emptying function and decreased sensation on cystometry and intravesical current perception threshold testing. The detrusor overactivity group showed impaired storage and emptying function but had no significant changes in intravesical current perception threshold values. When the normal detrusor function group and detrusor underactivity group were pooled to perform multivariate analysis, an increase in current perception threshold values was associated with a decrease in bladder voiding efficiency on 5 and 250 Hz current perception threshold testing.
Conclusions
Our data provide the electrophysiological evidence that indicates an association between impaired Aδ as well as C fiber bladder afferent pathways and poor emptying function in diabetic women with detrusor underactivity. Diabetes can affect the bladder presumably via peripheral pathogenetic mechanisms to induce detrusor overactivity with impaired contractility.
aDivision of Urology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
bCollege of Medicine, Chang Gung University, Taoyuan, Taiwan
cDepartment of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
dDepartment of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
eGraduate Institution of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Correspondence and requests for reprints: Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, 7 Chungshan South Rd., Taipei, Taiwan, 100 (telephone: 011-886-2-23562135; FAX: 011-886-2-23219145)
Supported by BMRP 988 from Chang Gung Memorial Hospital.
Study received Research Ethics Committee approval, National Taiwan University Hospital.
See Editorial on page 13.
For another article on a related topic see page 379.
ABSTRACT