Diabetic bladder dysfunction: current translational knowledge.
Authors Daneshgari F, Liu G, Birder L, Hanna-Mitchell AT, Chacko S
Submitted By Firouz Daneshgari on 3/31/2010
Status Published
Journal The Journal of urology
Year 2009
Date Published 12/1/2009
Volume : Pages 182 : S18 - S26
PubMed Reference 19846137
Abstract 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.

Investigators with authorship
Lori BirderUniversity of Pittsburgh Medical Center-Health System
Firouz DaneshgariCase Western Reserve