Diabetic neurogenic bladder.
Diabetic neurogenic bladder.
KoreaMed
During the last ten years, 7.384 patients with diabetes mellitus were managed at Seoul National University Hospital. Among them 1,026 patients (13.9%) were diagnosed as diabetic neuropathy and 84 (1.1 %) as diabetic neurogenic bladder with severe voiding dysfunction. We analyzed clinical informations. laboratory and radiologic findings. results of urodynamic study and treatment modalities and outcomes. Thirty one patients were eligible, including 13 men and 18 women. The mean duration of diabetes was 9.4 years before severe voiding dysfunctions developed. Significant amount of residual urine was detected in all patients ranging from 300cc to 1,900 cc. Urodynamic study was done in 16 patients, all showed flaccid neurogenic pattern with increased bladder capacity over 500cc. Bacteriuria was found in 24 patients (77.4%), including 8 mixed infections. Hydronephrosis was identified in 7 out of 11 radiologically evaluated patients. Other diabetic chronic complications were found in most of the patients. diabetic retinopathy in 24 (77.4%). nephropathy in 13 (41.9%). and peripheral neumpathy in 24 (77.4%). They were managed successfully with timed voiding and double voiding in 2 patients, and urecholine medication with or without phenoxybenzamine in 6. and intermittent catheterization in l8. Education of the patients and high suspicion and full recognition of medical persons about diabetic neurogenic bladder is necessary for decrement of the development of diabetic neurogenic bladder, for early detection and prevention of severe complication such as renal and bladder impairment.
