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2009 ; 182
(6 Suppl
): S18-26
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Diabetic bladder dysfunction: current translational knowledge
#MMPMID19846137
Daneshgari F
; Liu G
; Birder L
; Hanna-Mitchell AT
; Chacko S
J Urol
2009[Dec]; 182
(6 Suppl
): S18-26
PMID19846137
show ga
PURPOSE: Diabetes mellitus, a metabolic disorder caused by an absolute or
relative deficiency of insulin, is a debilitating and costly disease with
multiple serious complications. Lower urinary tract complications are among the
most common complications of diabetes mellitus. The most common, bothersome lower
urinary tract complication of diabetes mellitus is diabetic cystopathy or
diabetic bladder dysfunction. We reviewed the current translational knowledge of
diabetic bladder dysfunction. MATERIALS AND METHODS: We performed a search of the
English literature through PubMed. The key words used were diabetes and bladder
dysfunction or cystopathy. Our data and perspective are provided for
consideration of the future direction of research. RESULTS: Despite traditional
recognition of diabetic bladder dysfunction as a voiding problem characterized by
poor emptying and overflow incontinence, recent clinical and experimental
evidence indicate storage problems such as urgency and urge incontinence in
diabetes mellitus cases. Recent experimental evidence from studies of diabetic
bladder dysfunction in small animal models of diabetes mellitus show a temporal
effect on diabetic bladder dysfunction. Early phase diabetes mellitus causes
compensated bladder function and the late phase causes decompensated bladder
function. The temporal theory could plausibly provide the scientific road map to
correlate clinical and experimental findings, and identify the role of mechanisms
such as polyuria, hyperglycemia, oxidative stress, autonomic neuropathy and
decompensation of the bladder contractile apparatus in the creation of clinical
and experimental manifestations of diabetic bladder dysfunction. CONCLUSIONS:
Diabetic bladder dysfunction includes time dependent manifestations of storage
and emptying problems. Identifying mechanistic pathways would lead to the
identification of therapeutic intervention.
|Antioxidants/pharmacology
[MESH]
|Diabetes Mellitus/*physiopathology
[MESH]
|Humans
[MESH]
|Lipid Peroxidation
[MESH]
|Oxidative Stress
[MESH]
|Risk Factors
[MESH]
|Time Factors
[MESH]
|Urinary Bladder Diseases/*etiology/*physiopathology/prevention & control
[MESH]
|Urinary Bladder, Neurogenic/etiology/physiopathology/prevention & control
[MESH]