Diabetes mellitus and female lower urinary tract symptoms: A review

Hill, Simon; Fayyad, Abdalla; Jones, Geraint

doi:10.1002/nau.20533

Cited by 100 publications

(93 citation statements)

References 63 publications

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“…DBD often develops insidiously, and obvious symptoms do not appear until the disease is in an advanced stage. The DBD in the later stage is characterized by the increase in post-void residual urine and bladder capacity with diminished bladder sensation and decreased bladder contractility, 25 which might be a result of the chronic hyperglycemia-related oxidative stress and long-term polyuria. The treatment for DBD in the later phase is basically conservative, aiming to eliminate symptoms.…”

Section: Discussionmentioning

confidence: 99%

Short‐term diabetes‐ and diuresis‐induced alterations of the bladder are mostly reversible in rats

et al. 2015

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Abbreviations & Acronyms CMG = cystometrogram Con 3w = 3 weeks agematched controls Con 11w = 11 weeks agematched controls DBD = diabetic bladder dysfunction DIU = 5% sucrose-induced diuresis DIU 3w = 3 weeks after 5% sucrose-induced diuresis DIU 3 + 8w = 3 weeks after 5% sucrose-induced diuresis followed by 5% sucrose removal for 8 weeks DIU 11w = 11 weeks after 5% sucrose-induced diuresis DM = diabetes mellitus DM 3w = 3 weeks after streptozotocin-induced diabetes mellitus DM 3 + 8w = 3 weeks after streptozotocin-induced diabetes mellitus followed by insulin replacement treatment for 8 weeks DM 11w = 11 weeks after streptozotocin-induced diabetes mellitus HbA1c = glycated hemoglobin A1c STZ = streptozotocin Objectives: To determine whether diabetes mellitus-and diuresis-induced alterations in the bladder can be reversed in rats. Methods: Male Sprague-Dawley rats were randomly distributed into eight groups (n = 16 per group): 3 weeks and 11 weeks age-matched controls, 3 weeks and 11 weeks after streptozotocin-induced diabetes mellitus, 3 weeks after diabetes mellitus induction then treated with insulin for 8 weeks, 3 weeks and 11 weeks after 5% sucrose-induced diuresis, and 3 weeks after 5% sucrose-induced diuresis followed by removal of 5% sucrose for 8 weeks. Bodyweight, blood glucose and glycated hemoglobin A1c were monitored. At the designated time-points, 24-h urinary habits were examined, and cystometry was carried out in half of the animals. The bladders from the remaining animals were harvested for histological examination, and quantification of smooth muscle, urothelium and collagen components. Results: Insulin treatment reversed hyperglycemia and polyuria in diabetic animals successfully, which was shown by normalization of blood glucose, glycated hemoglobin A1c and 24-h urinary habits. Subsequently, bodyweight, bladder weight and percentage change of bladder components (smooth muscle, collagen, urothelium) in total bladder crosssectional area were reversed to almost normal levels, and the bladder dysfunction was mostly reversed by 8 weeks of glycemic control, seen in the cystometry study. Similar alterations and reversed effects were seen in diuretic rats without and with 5% sucrose removal, respectively. Conclusions: Short-term (3-week induction) diabetes-and polyuria-induced functional and morphological alterations of the bladder can mostly be reversed in rats.Key words: bladder, diabetes, insulin, morphology, smooth muscle. IntroductionDBD, a collective description of clinical symptoms, including decreased sensation, increased capacity, poor emptying 1 and detrusor overactivity, 2 is among the most common and costly complications of DM.3 It is estimated that DBD occurs in approximately 87% of individuals diagnosed with DM, a higher rate than that of widely recognized complications such as neuropathy (60%) and nephropathy (50%).1,3 Although DBD is not life threatening, it substantially affects quality of life. 4The classic symptoms of untreated DM are loss of weight, polyuria, polydipsia and polypha...

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Section: Discussionmentioning

confidence: 99%

Short‐term diabetes‐ and diuresis‐induced alterations of the bladder are mostly reversible in rats

et al. 2015

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“…[4][5][6][7][8][9] We have reported, in a recent review of LUTS in women suffering from DM that storage symptoms are common in these women. 20 These symptoms are commonly attributed to increased urine production, accepted as part of the disease process, but without scientific basis.…”

Section: Discussionmentioning

confidence: 99%

Urine production and bladder diary measurements in women with type 2 diabetes mellitus and their relation to lower urinary tract symptoms and voiding dysfunction

Fayyad

Hill

Jones

2009

Neurourology and Urodynamics

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“…Its major symptoms are dysuria, polaciuria, nocturia, urinary urgency and incomplete bladder emptying. These factors, added to DM-related immunosuppression, increase the prevalence of repetitive urinary tract infections, contributing to the development of renal failure among these patients 39 . Sudomotor dysfunction in diabetic AN results in trophic changes in extremities, being associated to Charcot arthropathy, LLll ulcers and amputations.…”

Section: Autonomic Neuropathy (An)mentioning

confidence: 99%