Urinary bladder dysfunction in diabetic children with and without subclinical cardiovascular autonomic neuropathy

Barkai, László; Szabo, L

doi:10.1007/bf01956141

Cited by 18 publications

(12 citation statements)

References 24 publications

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“…Cystometrograms exhibited sig-ni¢cant increases in bladder volume at ¢rst desire to void and maximal bladder capacity, and a decrease in detrusor contractility in diabetic patients compared to those in controls. We found increased bladder capacity in our earlier study [Barkai and Szabo, 1993]. Children with diabetes mellitus who were tested with uro£ow had a signi¢cantly increased voiding volume, increased average urinary £ow, and increased delay until the ¢rst sensation of the need to void, compared with healthy children.…”

Section: Discussionsupporting

confidence: 51%

“…In our earlier study we compared bladder sensation of diabetic children with cardiovascular autonomic dysfunction (CAD) and without CAD. These ¢ndings suggest that diabetic children may have diminished sensation of bladder ¢lling independent of impaired cardiovascular re£exes, however, the degree of bladder dysfunction parallels with CAD, both depending on diabetes duration and long-term glycometabolic control [Barkai and Szabo, 1993]. The aim of present study is to determine the early disturbances of the detrusor contractility in children, and adolescents with type 1 diabetes.…”

Section: Introductionmentioning

confidence: 94%

“…However, adult diabetic patients have concomitant lesions, such as benign prostate hyperplasia, stress incontinence, bladder or prostate cancer and infection, which may coexist with or mimic the symptoms of diabetic cystopathy [Kaplan et al, 1995]. Clinical manifestations of voiding dysfunction in children with diabetes are fortunately very rare, but only few data have been published [Barkai and Szabo, 1993;Wahl et al, 2001]. In our earlier study we compared bladder sensation of diabetic children with cardiovascular autonomic dysfunction (CAD) and without CAD.…”

Section: Introductionmentioning

confidence: 99%

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Urinary flow disturbance as an early sign of autonomic neuropathy in diabetic children and adolescents

Szabo

Barkai

Lombay

2006

Neurourology and Urodynamics

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Section: Discussionsupporting

confidence: 51%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Urinary flow disturbance as an early sign of autonomic neuropathy in diabetic children and adolescents

Szabo

Barkai

Lombay

2006

Neurourology and Urodynamics

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“…In the present study, the mean values of age and disease duration were significantly higher in patients with neuropathy than in patients without neuropathy. The fact that diabetic microvascular complications, including neuropathy, are usually long term complications requiring longer disease duration can explain that [17][18][19][20][21]. There was no gender difference between the two studied groups as sex is not a recognized predisposing factor for development of diabetic neuropathy [18].…”

Section: Discussionmentioning

confidence: 99%

Diabetic cystopathy in children and adolescents with Type 1 diabetes mellitus

Salem¹,

Habashy²,

Toaima³

et al. 2014

JDM

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Background: Urinary bladder dysfunction is a major complication of diabetes mellitus and its mechanism has been attributed to autonomic and/or peripheral neuropathy. Objectives: Evaluation of diabetes mellitus and neuropathy effect on the urinary bladder dynamics in children and adolescents with Type 1 diabetes mellitus. Patients and Methods: The study included 80 children and adolescents with Type 1 diabetes for at least 5 years; 60 patients were with manifestations of autonomic and/or peripheral neuropathy and 20 patients were free of either. We assessed both groups for presence of cystopathy by means of uroflowmetry and cystometry. Results: All patients with diabetic neuropathy had abnormal urodynamic test results of variable types and degrees with bladder hypercompliance as the most frequent abnormality. Other urodynamic abnormalities were found in both diabetic patients' groups with no significant difference in frequency. Conclusions: Diabetic neuropathy might be strongly related to urodynamic abnormalities particularly the bladder hypercompliance. Some diabetic patients may have cystopathy in absence of evident neuropathy. This may be due to undetected neuropathy or diabetes induced myopathy of the detrusor muscle.

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“…Although asymptomatic urodynamic changes have been found in diabetic children with or without neuropathy (Faerman et al, 1971;Barkai & Szabo, 1993), the symptoms of diabetic cystopathy are more likely to present problems in older patients.…”

Section: Introductionmentioning

confidence: 99%

Factors underlying the increased sensitivity to field stimulation of urinary bladder strips from streptozotocin‐induced diabetic rats

Tammela

Briscoe

Levin

et al. 1994

British J Pharmacology

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1 The responses of bladder strips from control, streptozotocin-diabetic, and sucrose-drinking rats to electrical field stimulation were investigated. Sucrose-drinking rats were included as additional controls because they have enlarged bladders as a result of non-diabetic diuresis. 2 Bladder strips from diabetic rats developed more spontaneous activity than those from the two control groups. Indomethacin reduced the amplitude and frequency of spontaneous contractions suggesting that they resulted from endogenous prostaglandin formation. Tetrodotoxin (TTX) had little effect, while a,-methylene ATP caused increases in spontaneous activity.3 Bladder strips from diabetic rats responded to field stimulation with greater contractions than controls in the absence of antagonists as well as in the presence of atropine and at,p-methylene ATP.Increasing TTX concentrations caused a step-wise depression of the contractile response to electrical stimulation which was not affected by preincubation with either atropine or a,-methylene ATP.4 Atropine and indomethacin had no effect on stength-duration curves constructed to measure threshold contractile responses to five pulses stimulation. The curves were shifted to the right by both TTX and a,-methylene ATP, indicating that the responses were neurogenic in nature and at least partially, the result of stimulation of P2-purinoceptors. In the absence of drugs, bladder strips from diabetics responded at lower voltages and pulse widths than those of control and sucrose-drinking rats, suggesting that they were more excitable. 5 The response curve of bladder strips from diabetics to field stimulation at increasing voltage was shifted upwards and to the left compared to strips from control or sucrose-drinking rats. 6 Bladder strips from diabetics responded to stimulation at increasing pulse width with greater responses than those from control or sucrose-drinking rats. At 1.0 ms pulse width, the TTX-resistant response of strips from diabetic rats was still greater than that of the other groups, indicating that a myogenic component was also involved. 7 The data suggest that bladder strips from diabetic rats are more excitable than those of control or sucrose-drinking rats. This may result from diabetes-induced decreases in bladder lipid or other membrane changes, and/or be a result of partial depolarization, perhaps related to diabetic neuropathy.

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Urinary bladder dysfunction in diabetic children with and without subclinical cardiovascular autonomic neuropathy

Cited by 18 publications

References 24 publications

Urinary flow disturbance as an early sign of autonomic neuropathy in diabetic children and adolescents

Urinary flow disturbance as an early sign of autonomic neuropathy in diabetic children and adolescents

Diabetic cystopathy in children and adolescents with Type 1 diabetes mellitus

Factors underlying the increased sensitivity to field stimulation of urinary bladder strips from streptozotocin‐induced diabetic rats

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