Urodynamic Evaluation in Simultaneous Insulin-Dependent Diabetes Mellitus and End Stage Renal Disease

Menéndez, Violeta; Cofan, Frederic; Talbot-Wright, R; Ricart, M. J.; Gutiérrez, R; Carretero, P

doi:10.1097/00005392-199606000-00054

Cited by 16 publications

(20 citation statements)

References 13 publications

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“…In another study, Menendez et al reported urodynamic abnormalities in 86% of patients with end-stage renal disease due to diabetic nephropathy [27], which indicates that autonomic neuropathy might also be a factor of importance, but perhaps not in childhood.…”

Section: Discussionmentioning

confidence: 99%

Bladder dysfunction in children and adolescents after renal transplantation

Herthelius

Öborn

2006

Pediatr Nephrol

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The underlying mechanisms of urinary-tract infections (UTI) in renal transplant recipients are still not fully understood. In otherwise healthy children, bladder dysfunction increases the susceptibility to UTI. The aim of this study was to evaluate lower-urinary-tract function in children and adolescents after renal transplantation. Sixty-eight recipients of renal transplants, 5-20 years of age and 1-15 years after transplantation, were evaluated for their bladder function with a questionnaire, uroflowmetry and bladder ultrasound, and for renal function (glomerular filtration rate) by measuring clearance of inulin or iohexol. Forty-nine patients (72%) had some type of abnormality of bladder function. Abnormal bladder capacity was found in 26%, abnormal urinary flow in 50% and residual urine in 32% of the patients. There was no significant difference in bladder or renal function in children with urinary-tract malformations compared with those with normal urinary tract. Furthermore, there was no significant difference in renal function in patients with bladder dysfunction compared with those without. The incidence of bladder dysfunction is high in children and adolescents after renal transplantation, but the clinical significance of this finding and whether there is a correlation between bladder dysfunction and UTI in these patients need to be clarified further.

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Section: Discussionmentioning

confidence: 99%

Bladder dysfunction in children and adolescents after renal transplantation

Herthelius

Öborn

2006

Pediatr Nephrol

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“…Elle est censée affecter 40 à 85 % des patients diabétiques [3,7,8]. Cette prévalence passe de 75 à 100 % en présence d'une neuropathie périphérique [3] et s'inscrit dans une association neuropathie périphérique-dysautonomie cardiovasculaire-cystopathie diabétique dans 40 % des cas [9].…”

Section: Aspects Cliniquesunclassified

“…Le lien entre microalbuminurie et résidu post-mictionnel [11] ou incontinence chez la femme [56] n'est le témoin que des diabètes les plus évolués. Ainsi, l'incidence des troubles vésico-sphinctériens est relevée à 84 % au terme de 21 ± 6 ans d'évolution du diabète, 86 % des patients étant sous dialyse [73]. La symptomatologie urinaire résulte des conséquences conjointes de l'insuffisance terminale et de l'atteinte dysautonomique et semble dépendre de paramètres tels que la durée de la dialyse, de la durée d'évolution du diabète et de la diurèse résiduelle [74].…”

Section: Troubles Mictionnels Et Insuffisance Rénaleunclassified

Les troubles vésicosphinctériens du diabète

Kerdraon¹,

Busnel²,

Coignard³

et al. 2008

Pelv Perineol

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Plus de la moitié des patients diabétiques, indépendamment du sexe, sont porteurs d'un déséquilibre vésicosphinctérien [1,2]. Le diabète est classiquement décrit comme déterminant une réduction progressive de la sensation de besoin, une réduction de la contractilité du détrusor et une augmentation progressive du résidu post-mictionnel, tous symptômes correspondant à la cystopathie diabétique [3]. Cette manifestation pathologique est une des expressions de la neuropathie diabétique dont l'histoire naturelle est bien reproduite chez l'animal et implique des mécanismes modulant l'expression de facteurs neurotrophiques. De nombreuses études ont cependant relevé chez les patients diabétiques une hyperactivité vésicale comme manifestation prévalente. C'est dans ce cadre que se discute toujours la part des pathologies d'organe, les conséquences de la macro-angiopathie, de la micro-angiopathie, de l'hyperglycémie ou des autres manifestations du syndrome métabolique dans la genèse de ces troubles. De même, les contributions respectives du déséquilibre vésicosphinctérien ou du diabète dans la genèse des complications uronéphrologiques et infectieuses de ces patients restent mal établies. Il est cependant démontré que le bon équilibre du diabète ainsi que les mesures hygiénodiététiques différaient la survenue de la cystopathie diabétique ainsi que la fréquence et la sévérité de l'incontinence urinaire chez la femme. De nouveaux développements thérapeutiques prometteurs concernant la dysfonction autonome du diabète sont aussi en cours. Mots clés : Diabète -Cystopathie -Hyperactivité vésicale Lower urinary dysfunction in diabetes mellitusAbstract: Over half of men and women with diabetes mellitus have a bladder dysfunction [1,2]. Voiding dysfunction in diabetes is classically described as the triad of decreased bladder sensitivity, increased post-voiding residue and impaired detrusor contractility, all typical symptoms of classic diabetic cystopathy [3]. Diabetic cystopathy is one expression of the diabetic polyneuropathy, which may be reproduced in animal models presenting with a long-term decrease in neurotrophic factors. In addition, recent studies have shown overactive bladder to be a prevalent manifestation of diabetes mellitus. Regarding pathophysiology, it is hypothesised that overactive bladder may occur as a result of macroangiopathy, microangiopathy and hyperglycemia as well as other disorders belonging to the metabolic syndrome. The respective contributions of voiding dysfunction and diabetes in the pathogenesis of uronephrologic and infectious complications need further study. It is however well established that general good health and measures taken with respect to diet in diabetes may put off the development of the autonomic cystopathy as well as the frequency and severity of incontinence in women. New promising therapies in diabetic cystopathy and related disorders are also ongoing.

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“…Menéndez et al [4] performed urodynamics in a group of 51 young patients made up of 35 men and 16 women (36 ± 6 years) with insulin-dependent diabetes and end stage renal disease. They found an abnormal outcome in 84% of the patients.…”

Section: Introductionmentioning

confidence: 99%

Effect of diabetes mellitus on lower urinary tract symptoms and dysfunction in patients with benign prostatic hyperplasia

Eckhardt

2001

Curr Urol Rep

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This article reviews the recent literature on men with diabetes mellitus (DM) and concomitant lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Diabetes is reported to be associated with greater BPH symptom severity. Men with non-insulin-dependent diabetes had the highest median annual prostate growth rate compared with those who had other metabolic disease. Urodynamic evaluations in the reviewed studies were absent. Extensive diagnostic evaluations with urodynamics in our outpatient department revealed that patients with LUTS suggestive of BPH and with concomitant DM hardly differed from those without DM.

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Urodynamic Evaluation in Simultaneous Insulin-Dependent Diabetes Mellitus and End Stage Renal Disease

Abstract: A high frequency of vesical alterations was observed, which were modified by association of progressive vesical dysfunction and diabetes mellitus. In diabetes mellitus dialysis protects against detrusor hypocontractility but predisposes the patients to have bladder obstruction.

Cited by 16 publications

References 13 publications

Bladder dysfunction in children and adolescents after renal transplantation

Bladder dysfunction in children and adolescents after renal transplantation

Les troubles vésicosphinctériens du diabète

Effect of diabetes mellitus on lower urinary tract symptoms and dysfunction in patients with benign prostatic hyperplasia

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