title: Overactive bladder in diabetes: a peripheral or central mechanism?
abstract: OBJECTIVE
  To study diabetic cystopathy with reference to overactive bladder (OAB).
  
  
  METHODS
  We retrospectively analyzed diabetic cystopathy in our digitized database that comprised 2300 case records, including data from a lower urinary tract symptoms questionnaire, data from a urodynamic study, and data from neurological examinations.
  
  
  RESULTS
  Diabetic cystopathy was seen in 4% of cases (84 cases): 58 males, 26 females; mean age, 60.8 years; duration of diabetes, 143.5 months; HbA1C, 7.7 %. In addition to large post-void residual and decreased sensation, OAB, detrusor overactivity (DO), and increased bladder sensation were seen in 55%, 42%, and 14%, respectively. The frequency of DO in patients with increased bladder sensation was 58%. DO increased with age, but not with the duration of diabetes. A brain MRI was performed in 32 cases. The frequency of multiple cerebral infarction (MCI) in patients with DO was 76.5%. The remaining 23.5% of patients with DO had no MCI, and the remaining 42% with increased bladder sensation had no DO.
  
  
  CONCLUSIONS
  OAB commonly occurs in diabetic cystopathy. Both central and peripheral mechanisms are involved, e.g., MCI due to diabetic cerebral vasculopathy for the DO, and, to a lesser extent, peripheral nerve irritation for the DO and increased bladder sensation.
authors.affiliation: Central Laboratory Unit, Department of Molecular Diagnosis, Chiba University, Chiba, Japan.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Yamaguchi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Ito
authors.forename: Zhi
authors.initials: Z
authors.lastname: Liu
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Awa
authors.forename: Kaori
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Fumio
authors.initials: F
authors.lastname: Nomura
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yamanishi
authors.forename: Takamichi
authors.initials: T
authors.lastname: Hattori
mesh_terms: D048909:Diabetes Complications / Q000097:blood / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D012189:Retrospective Studies; D012677:Sensation / Q000502:physiology; D001743:Urinary Bladder / Q000503:physiopathology*; D053201:Urinary Bladder, Overactive / Q000097:blood / Q000209:etiology* / Q000503:physiopathology*; D014551:Urinary Tract / Q000503:physiopathology; D014655:Vascular Resistance / Q000502:physiology
chemical_list: D006442:Glycated Hemoglobin