Men with LUTS and diabetes mellitus.
2014
Introduction: Diabetic urinary bladder disfunction is a common problem.
Disfunction will occur in about 80% of diabetic patients. Comon symptoms
include retention, overactive bladder, sfincted dissinergy and urinary tract
infections. Material and methods: In nine months period from 08.2013. to
05.2014. fourteen patients with lower urinary tract symptoms (LUTS) and
diabetes were evaluated by uroflowmetry, cistotonometry with electromyography
and pressure flow study. Including criteria consisted of IPSS more than 8,
PSA lower than 4, RT carcinoma excluded and prostate size more than 25cm3.
Results: Patient age was 50 to 77 years. In two patients due to acute
retention urinary catheter was inserted. Only they were treated with alfa
blockers while other patients received no therapy. Four patient had insulin
dependant diabetes while ten of them had diabetes regulated with oral
antidiabetics. Cistotonometry presented detrusor overactivity in two
patients, treated with M cholinergics. In one patient over-active detrusor
activity was in the same time presented with urge incontinence and treated in
the same way. Normal detrusor activity was recorded in 14 patients on
pressure flow evaluation. In 8 patients with Q max more than 15ml/s treatment
was watchfull waiting. In 4 patients with Q max more than 12ml/s alfa
blockers were introduced. In 2 patients with Q max less than 10ml/s bipolar
TURP was the treatment. Conclusion: Diabetes and diabetic bladder disfunction
will have a great impact on quality of life due to an aging population. All
specialities should be informed for diabetic bladder disfunction and
necesssity for recognition and treatment. Further investigation is needed in
terms of understanding the risk factors, mechanisms and the most adequate
therapy.
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