Diabetic Bladder Dysfunction: Current Translational Knowledge

Daneshgari, Firouz; Liu, Guiming; Birder, Lori A.; Hanna-Mitchell, Ann T.; Chacko, Samuel

doi:10.1016/j.juro.2009.08.070

Cited by 209 publications

(240 citation statements)

References 43 publications

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“…In this case the patient was in a state of "induced" post-renal acute renal failure for a very long period of time. Diabetic autonomic neuropathy may have aggravated the bladder disfunction in this patient (12). To our knowledge, there is no other reported case of endstage renal disease due to hydronephrosis caused by the lack of follow-up and intentional failure to regularly void the urine.…”

mentioning

confidence: 67%

End-Stage Renal Disease Due to Hydronephrosis in a Patient with Artificial Urinary Sphincter

et al. 2011

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A 65-year-old male with type II diabetes who had been on antidiabetic medication for 10 years was admitted to our hospital due to an altered state of consciousness, attributed to hypoglycemia, renal failure, and metabolic acidosis. From his medical history it was known that an artificial urinary sphincter (AUS) had been placed 9 years previously due to incontinence caused by reduced outlet resistance (also known as intrinsic sphincter deficiency) following prostate surgery. On placement of the AUS his renal function was normal (serum creatinine 1 mg/dL) and two years later he was diagnosed with a slightly deteriorated renal function (serum creatinine 1.8 mg/dL) without any urological follow-up until the day of admission to our clinic. On examination he was tachycardic (120 bpm) with tachypnoe, arterial hypertension (170/100 mmHg), edema of the lower extremities, and fine crackles on the lung bases. He was also suffering from dribbling during the last days and on palpation there was also found to be significant bladder distension. From the paraclinical examination he showed normochromic anemia (Ht=22%, Hb=7.6 gr/dL), severely compro- Accepted: May 11, 2011 CASE REPORT mised renal function (serum creatinine 6.4 mg/dL, serum urea 200 mg/dL), metabolic acidosis (pH=7.15, pCO 2 =20 mmHg, HCO 3 =10 mEq/L) and sterile leucocyturia (>100 per high power field). The urinary culture was negative. Pulmonary congestion was detected on the chest x-ray. A renal ultrasound revealed bilateral hydronephrosis with kidneys of normal size (left: 10.7 cm, right: 11.2 cm) increased echogenicity, and reduced thickness of the cortex, as well as the presence of an AUS in the pelvic area and the scrotum that was reconfirmed in the plain abdominal x-ray. Intravenous urography showed a slow parenchymal infiltration of the contrast media and a very slow excretory stage with a significant bladder distension. Other urological problems like ureteral or urethral stenosis were excluded as the urine flow was strong and uninterrupted after the activation of the AUS. Transdermal nephrostomies were inserted in order to assess the functional capacity of each kidney; the left one functioned properly with a urine volume of 2.5 L to 3 L per 24 hours. Despite the satisfactory urine output his renal function did not improve and he started chronic hemodialysis 22 days post-insertion of the nephrostomies.

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confidence: 67%

End-Stage Renal Disease Due to Hydronephrosis in a Patient with Artificial Urinary Sphincter

et al. 2011

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“…Portanto, o uso de ratas como modelo animal é apropriado para estudos experimentais que testam hipóteses sobre os mecanismos de continência e a fisiopatologia do binômio diabetes melito e IU, possibilitando, assim, soluções de grande valia na prática clínica (64). Vários estudos mostram que, após a indução do DM em roedores por destruição de células β-pancreáticas com STZ, a bexiga e a uretra sofrem alterações morfométricas e funcionais nos componentes miogênico e neurogênico (65)(66)(67)(68)(69).…”

Section: Aumento Da Incontinência Urinária Em Diabéticas Pós-parto Ceunclassified

Pesquisa translacional em diabetes melito gestacional e hiperglicemia gestacional leve: conhecimento atual e nossa experiência

Rudge

Pículo

Marini

et al. 2013

Arq Bras Endocrinol Metab

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RESUMOO diabetes materno constitui um ambiente desfavorável para o desenvolvimento embrionário e feto--placentário. É uma repercussão de importância na obstetrícia moderna, visto que está associado a um risco aumentado de morbidade materna e neonatal e continua a ser um desafio médico significativo. O aumento mundial na incidência do diabetes, o aumento do diabetes tipo 2 em mulheres em idade reprodutiva e a geração cruzada da programação intrauterina do diabetes tipo 2 são as bases para o interesse crescente na utilização de modelos experimentais diabéticos, a fim de obter conhecimento sobre os mecanismos que induzem as alterações de desenvolvimento no diabetes gestacional. Vários estudos têm demonstrado os benefícios da prevenção do diabetes com intervenções no estilo de vida, melhora metabólica e controle de fator de risco cardiovascular para evitar substancialmente as complicações devastadores da doença. Apesar desses achados e a revolução recente no conhecimento científico e infinidade de novas terapias do diabetes, continua a haver uma grande lacuna entre o que foi aprendido por meio da pesquisa e o que é feito na prática da saúde pública, clínica e comunitária. O iminente impacto econômico negativo dessa complacência nos indivíduos, nas famílias e nas economias nacionais é alarmante. Espera-se que a pesquisa translacional no binômio diabetes-gravidez seja implementada em centros de excelência tanto de pesquisa básica como aplicada e complementada por estudos clínicos multicêntricos, conduzidos de forma pragmá-tica para aumentar o nível de evidência científica com recursos diagnósticos e propedêuticos mais confiáveis. Arq Bras Endocrinol Metab. 2013;57(7):497-508 Descritores Diabetes; gestação; modelos animais; pesquisa translacional; incontinência urinária ABSTRACT Maternal diabetes constitutes an unfavorable environment for fetal-placental and embryonic development. It is has important repercussion in modern obstetrics, since it is associated to an increased risk of neonatal and maternal morbidity, and it still is a significant medical challenge. The increased occurrence of diabetes worldwide, the increase in diabetes type 2 in women at reproductive age and the crossed generation of intrauterine programming for diabetes type 2 are the bases for the growing interest in utilization of diabetic experimental samples, with the aim to acquire knowledge about the mechanisms that induce development alterations in gestational diabetes. Several studies have shown the benefits of diabetes prevention, with interventions in lifestyle, metabolic improvement and control of cardiovascular risk factors to substantially prevent the complications of this devastating disease. Despite these findings, the recent revolution in the scientific knowledge, and the infinite number of new therapies for diabetes, there is still a large gap between what was learned through research and what is really done in public, clinical and community health. The negative economic impact of this complacency in people, families, and national econom...

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“…However, it substantially affects QoL (3). LUTS are found in approximately 80% of people diagnosed with DM and classified into storage and voiding problems (4). Overactive bladder (OAB) syndrome is a condition that there is a frequent urge to urinate during the day and night and urinary urgency with or without incontinence.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Overactive Bladder in Type 2 Diabetes Patients with a Questionaire-Based Study

Verim¹,

Kayataş²,

Abanonu³

et al. 2016

Haseki

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Abs tractAim: Overactive bladder (OAB) is a common and well-known urologic condition. OAB occurs in both women and men. Diabetes mellitus (DM) is one of the most common metabolic disorders in the world and the prevalence of DM in adults has been increasing. Diabetic neuropathy can induce functional disease of multiple organs, including diabetic bladder dysfunction (DBD). DBD occurs commonly as a late complication and DBD is mainly characterized by poor bladder emptying, urinary retention and overflow incontinence. However, storage symptoms, as those suggestive for OAB may also affect people with DM. The aim of this study was to evaluate the prevalence of OAB in people with DM compared to healthy control subjects. Methods: We analyzed records of 212 diabetic case and 229 control subjects using the 8-item symptom bother scale of the OAB questionnaire (OAB-q) (OAB-V8). Results:Diabetic bladder overactivity was seen in 20.3% of patients with DM (n=43) and 10.5% of non-diabetic control group (n=24). The OAB prevalence in patients with DM was approximately two-fold higher than in control subjects. OAB increased with the duration of diabetes, glycosylated hemoglobin level and age. There was no significant difference in sex distribution between the groups. There is an increase in the prevalence type 2 diabetes in Turkey. DM is a common cause of reduced bladder sensation in both men and women. In this study, OAB syndrome in diabetic patients was searched. DBD is characterized by underactive (flaccid) bladder, voiding difficulty, infrequent voiding and reduced bladder sensation during urinary storage; bladder underactivity and urinary retention during urination. OAB in diabetic patients is characterized by urgency (a compelling and sudden desire to void), with or without incontinence, usually with urinary frequency and nocturia. Conclusion: OAB symptoms are more prevalent in diabetic people than in healthy people. OAB symptoms in DM may be considered as a predictor of the development of diabetic neuropathy. Thus, controlling the progression of DM might reduce the incidence of diabetic neuropathy and other late diabetic complications.

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Diabetic Bladder Dysfunction: Current Translational Knowledge

Cited by 209 publications

References 43 publications

End-Stage Renal Disease Due to Hydronephrosis in a Patient with Artificial Urinary Sphincter

End-Stage Renal Disease Due to Hydronephrosis in a Patient with Artificial Urinary Sphincter

Pesquisa translacional em diabetes melito gestacional e hiperglicemia gestacional leve: conhecimento atual e nossa experiência

Evaluation of Overactive Bladder in Type 2 Diabetes Patients with a Questionaire-Based Study

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