Urodynamic Findings in Diabetic Cystopathy / 대한비뇨기과학회지

ABSTRACT

PURPOSE: To evaluate the urodynamic findings in diabetics complaining of urinary voiding symptoms, the retrospective study was performed. MATERIALS AND METHODS: For 5 years, from Jan. 1992 to Dec. 1997, urodynamic findings on 76 diabetics(49 males and 27 females) with voiding dysfunction were assessed and classified into; 1, detrusor instability, 2, impaired detrusor contractility, 3, detrusor areflexia, 4, indeterminate, 5, normal. Diabetic patients who had diseases of influential potentiality on bladder function were excluded out. A detailed history of diabetes, past and present medical history were reviewed. In addition, a thorough voiding history, urine culture, blood chemistry and physical examination were determinate. Ophthalmic examination by ophthalmologist and sacral reflex arc examination by urologist were also examined. Those with abnormal sacral reflex arc(absent bulbocavernous reflex, lax anal sphincter tone and control) were deemed sacral cord signs positive, and those with intact sacral reflexes were deemed sacral cord signs negative. RESULTS: The urodynamic findings of 76 diabetic patients were distributed into 25(32.9%) detrusor instability 23(30.3%) impaired detrusor contractility, 21 (27.8%) detrusor areflexia, 6(7.9%) indeterminate and 1 (1.3%) normal. Thirty six(47.4%) of them had retinopathy and 27(35.5%) had positive sacral cord sign, those complications took place most frequently in diabetics with detrusor areflexia. CONCLUSIONS: Diabetic cystopathy revealed various patterns of bladder dysfunction, and detrusor areflexia patients showed high incidence of retinopathy and positive sacral cord sign. It is necessary that urodynamic studies should be done in diabetic cystopathy to characterize the treatment of voiding dysfunction.