A combined urodynamic and electrophysiological study of diabetic cystopathy.
OBJECTIVE
The aim of this study is to compare urodynamics and electrophysiological studies in the diagnosis of diabetic cystopathy.


METHODS
In this prospective study are included twenty six patients with diabetes mellitus diagnosed at least since 5 years; 17 patients with diabetes type II and 9 with type I. They were divided in two groups in respect to lower urinary tract symptoms (LUTS) and signs suggestive of lower urinary tract dysfunction (LUTD) according to the ICS standardization. Patients with LUTS/LUTD were included in Group A and patients without LUTS/LUTD in Group B. Patients underwent different studies: urodynamic, somatosensory evoked potentials (SSEP) of tibial and pudendal nerves, bulbocavernosus reflex (BCR), bulbocavernosus muscles' electromyography and motor evoked potentials after transcranial magnetic stimulation to indirectly investigate bladder's innervation.


RESULTS
Abnormal urodynamics were found in 13 patients of group A (92.9%) and in 5 of group B (47.1%). This difference was statistically significant (P=0.009). Abnormally prolonged latency of P40 of tibial SSEP was found in 11 patients of group A (78.6%) and in 4 of group B (33.3%) and this difference was also statistically significant (P=0.04). Differences between the two groups concerning: i) peripheral polyneuropathy; ii) pudendal SSEP, iii) dysfunction of central nervous system and iv) abnormal BCR were not statistically significant.


CONCLUSIONS
The study of tibial SSEP is an easily performed test and it is well correlated to abnormal urodynamics in diabetic patients with and without LUTD/LUTS.
Rapidi
Christina-Anastasia
CA
2nd Department of Physical and Rehabilitation Medicina, National Rehabilitation Center, Athens, Greece. rapidicha@hotmail.com
Karandreas
Nikos
N
Katsifotis
Charilaos
C
Benroubi
Marianna
M
Petropoulou
Konstantina
K
Theodorou
Charalambos
C
D000328:Adult; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D004576:Electromyography; D004594:Electrophysiology; D019054:Evoked Potentials, Motor / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination; D010502:Perineum / Q000294:innervation / Q000502:physiology; D012018:Reflex / Q000502:physiology; D013979:Tibial Nerve / Q000502:physiology; D050781:Transcranial Magnetic Stimulation; D001743:Urinary Bladder / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*; D014570:Urologic Diseases / Q000503:physiopathology*