Overactive bladder in diabetes: A peripheral or central mechanism?

Yamaguchi, Chiharu; Sakakibara, Ryuji; Uchiyama, Tomoyuki; Yamamoto, Tatsuya; Ito, Takashi; Liu, Zhi; Awa, Yusuke; Yamamoto, Kaori; Nomura, Fumio; Yamanishi, Tomonori; Hattori, Takamichi

doi:10.1002/nau.20404

Cited by 98 publications

(86 citation statements)

References 47 publications

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“…These findings are different from other reports that noticed increased PVR and decreased functional capacity in diabetic DO individuals (2,15); but similar to those suggesting that conditions affecting nervous system may induce stronger overactive contractions at higher volume (16).…”

Section: Discussioncontrasting

confidence: 99%

“…Both peripheral autonomic neuropathy and central nervous system dysfunction due to cerebral vasculopathy are implied in the aetiology of DO in diabetic patients (2,23). However, this kind of diabetic bladder dysfunction can also be present in the absence of CNS lesions (2).…”

Section: Discussionmentioning

confidence: 99%

“…Both central and peripheral mechanisms have been implicated; namely, diabetic cerebral vasculopathy and peripheral nerve stimulation as well as changes in the detrusor muscle and urothelium (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

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Detrusor overactivity in diabetic and non-diabetic patients: is there a difference?

2012

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ARTICLE INFO _________________________________________________________ ___________________Purpose: To compare urodynamic characteristics in patients with idiopathic detrusor overactivity (IDO) with those of an age matched cohort with diabetes mellitus (DM) and detrusor overactivity (DO). Secondly, to determine whether urodynamic features could help distinguish these two groups of patients. Materials and Methods: Urodynamic data was collected on 58 female patients; 29 with IDO and 29 with DM and detrusor overactivity. Eight urodynamic parameters were selected for analysis: amplitude of the first overactive contraction (AOFC), the volume at the first contraction, cystometric capacity, maximal detrusor pressure, maximal flow rate, voiding pressure at maximal flow, voided volume and postvoid residual (PVR) urine volume. Finally, sensitivity analysis for distinguishing urodynamic parameters between studied groups was performed. Results: AOFC, volume at AOFC and maximal detrusor pressure were statistically greater in diabetic patients, compared with the non-diabetic group of women (16.00 cm H 2 O versus 9.00 cm H 2 O, 309.00 mL versus 167.00 mL and 76.48 cm H 2 O versus 55.41 cm H 2 O respectively). A specificity of 72.41% and positive predictive value of 71.43% were achieved for AOFC with cutoff value of 12 cm H 2 O. These parameters were further improved with cutoff value of 258 mL for volume at AOFC and were 75.86% and 73.08% respectively. Conclusions: Certain urodynamic parameters in diabetic female patients with DO are shown to be significantly different than those in women with IDO. Further prospective study should provide additional information about the pathogenesis and progression of DO in diabetic patients as well as the validity of diabetic screening in patients with IDO.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Detrusor overactivity in diabetic and non-diabetic patients: is there a difference?

2012

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“…Since the storage and periodic expulsion of urine as lower urinary tract functions are integratively controlled by both central and peripheral nerves, DPN itself can be a cause of OAB. In addition, recent papers also show evidences that OAB in patients with diabetes could be due to multiple factors that originate in diabetic vasculopathy, such as chronic ischemia in the bladder [19,20] and central nervous system [21].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of overactive bladder and its related factors in Japanese patients with diabetes mellitus

Ikeda

Nozawa

2015

Endocr J

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“…Detrusor myopathy [2], Fowler's syndrome [3], spina bifida occulta [4], multiple sclerosis [5], sacral herpes [6], meningitis-retention syndrome [7], and multiple system atrophy (MSA) [8] are all conditions that may cause female urinary retention as the sole initial symptom. Recently, however, there is also growing evidence that common neurologic diseases, e.g., lumbar spondylosis (LS, also called lumbar canal stenosis) [9,10] and diabetic polyneuropathy (DPN) [11,12] may cause urinary retention, particularly in middle-aged/elderly women. However, it remains unclear to what extent these neurologic diseases contribute to female urinary retention.…”

Section: Introductionmentioning

confidence: 99%

Neurologic diseases that cause female urinary retention

Nakamura

Sakakibara

Sugiyama

et al. 2016

Bladder

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A B S T R A C T OBJECTIVE:The pathogenesis of female urinary retention is not well known. Hence, we systematically investigated the frequency of diseases that underlie female urinary retention in a urodynamic laboratory. METHODS:We analyzed data from 450 consecutive female patients. Data registries included the diagnosis, lower urinary tract symptom questionnaires, urodynamic study results, and neurologic exam observations. Complete urinary retention is defined as mean post-void residual (PVR) urine volume > 100 ml with no voluntary void at all; whereas incomplete urinary retention is defined as mean PVR urine volume > 100 ml after voluntary partial void. RESULTS:Sixty of the 450 female patients visiting our lab (13%) had urinary retention with 4 (6.7%) of these having complete retention and 56 (93.3%) having incomplete retention. The most common underlying disease in these 60 patients was lumbar spondylosis (LS), 38.3% (with 16 patients having LS alone and 7 having LS & diabetic distal polyneuropathy [DPN]), multiple system atrophy (MSA), 18.3%, and DPN, 14.4% (with 2 patients having DPN alone and 7 having LS & DPN), followed by drug-induced retention (e.g., by antidepressants), 8.3%, acute myelitis of possible demyelinating origin, 5.0%, and other etiologies. An underactive detrusor was the major urodynamic findings in those patients. CONCLUSIONS:The present study revealed that common etiologies for female urinary retention are neurologic, e.g., an underactive detrusor due to MSA, age-related LS, and lifestyle-related DPN. Therefore LS and DPN, both common diseases, should also become major treatment targets in order to maximize patients' quality of life.

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Overactive bladder in diabetes: A peripheral or central mechanism?

Abstract: OAB commonly occurs in diabetic cystopathy. Both central and peripheral mechanisms are involved, e.g., MCI due to diabetic cerebral vasculopathy for the DO, and, to a lesser extent, peripheral nerve irritation for the DO and increased bladder sensation.

Cited by 98 publications

References 47 publications

Detrusor overactivity in diabetic and non-diabetic patients: is there a difference?

Detrusor overactivity in diabetic and non-diabetic patients: is there a difference?

Prevalence of overactive bladder and its related factors in Japanese patients with diabetes mellitus

Neurologic diseases that cause female urinary retention

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