Men with LUTS and diabetes mellitus.

Area of Science:

• Urology
• Endocrinology
• Diabetology

Background:

• Diabetic bladder dysfunction is a prevalent complication affecting approximately 80% of diabetic patients.
• Common symptoms include urinary retention, overactive bladder, sphincter dyssynergia, and recurrent urinary tract infections.

Purpose of the Study:

• To evaluate lower urinary tract symptoms (LUTS) in diabetic patients.
• To assess the diagnostic utility of uroflowmetry, cystotonometry with electromyography, and pressure-flow studies.
• To determine appropriate management strategies based on urodynamic findings.

Main Methods:

• Fourteen patients with LUTS and diabetes underwent urodynamic evaluation.
• Inclusion criteria included IPSS > 8, PSA < 4, no history of prostate cancer, and prostate size > 25 cm³.
• Therapeutic interventions ranged from watchful waiting and alpha-blockers to anticholinergics and bipolar TURP, guided by urodynamic results.

Main Results:

• Two patients required urinary catheterization due to acute retention and were treated with alpha-blockers.
• Cystotonometry revealed detrusor overactivity in three patients, managed with anticholinergics.
• Pressure-flow studies showed normal detrusor activity in 14 patients; management varied based on Qmax, including watchful waiting, alpha-blockers, or bipolar TURP.

Conclusions:

• Diabetic bladder dysfunction significantly impacts quality of life, particularly in an aging population.
• Increased awareness among healthcare professionals is essential for timely diagnosis and treatment.
• Further research is needed to elucidate risk factors, underlying mechanisms, and optimal therapeutic approaches.