J. Smooth Muscle Res. (Jap. Section) 5: J-59--J-67, 2001 URODYNAMIC STUDY IN DIAGNOSIS OF DIABETIC DYSURIA Minoru SATO First Department of Urology, To

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1 J. Smooth Muscle Res. (Jap. Section) 5: J-59--J-67, 2001 URODYNAMIC STUDY IN DIAGNOSIS OF DIABETIC DYSURIA Minoru SATO First Department of Urology, Toho University School of Medicine, Omori-nishi, Ota-ku, Tokyo Treatment of patients with diabetes-induced urinary disturbance requires consideration of many factors, due to wide variations. Attempts were made to classify the patients with diabetic urinary disturbance into subgroups, based on clinical point of views. In 57 patients with diabetic urinary disturbance, the cystourethral function was classified conventionally by using the following indicators: the cystometrographic curve in urodynamic studies, the maximum urethral closure pressure and the functional urethral length. Patients in individ ual groups were further divided into subgroups, based on the following factors the remain ing urinary volume, the curve pattern of urinary flow volume, the degree of incontinentia, the length after appearance of diabetic conditions, and the degree of diabetic neuropathy. Each group of patients was compared, based on the ratio of these factors involved. There was no positive relationship between the cystometrogram curve, the maximum urethral closure pressure, and the functional urethral length. No positive relationship was also observed between the remaining urinary volume as an index for severity of diabetic urinary distur bance, the volume of urinary flow, and the incontinentia. Each index parameter presented in the urodynamic study is not causally related to the length of the appearance of diabetes mellitus. Although the diabetic urinary disturbance is generally considered peripheral due to neuropathy, this study suggests that it is not simply applicable to the classification of diabetic urinary disturbances. The results suggest the diagnosis and treatment of bladder disturbances require understandings of individual bladder and urethral functions based on accurate urodynamic studies. Key words : Diabetes, urinary disturbance, bladder function, urethral function, urodynamic study

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3 Fig. 1. Numbers of cystometrogram pattern (n =57) Fig. 2. Pattern of cystometrogram *Complication of central and peripheral nerve. Normal bladder : 2 cases, Hyperactive bladder : 2 cases

4 Table 1. Normal range of maximum urethral closure pressure (Pmax) Fig. 3. Numbers of maximum urethral closure pressure (UPmax) (n=56)

5 Fig. 4. Maxmum urethral closure pressure (UPmax) *Complication of central and peripheral nerve. Normal : 3 cases Increase : 1 case Fig. 5. Numbers of functional profile length (FPL) (n=55)

6 Fig. 6. Functional profile length (FPL) *Complication of central and peripheral nerve. Increase : 4 cases

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