Men with LUTS and diabetes mellitus

Diabetic urinary bladder disfunction is a common problem. Disfunction will occur in about 80% of diabetic patients. Comon symptoms include retention, overactive bladder, sfincted dissinergy and urinary tract infections.

In nine months period from 08.2013. to 05.2014. fourteen patients with lower urinary tract symptoms (LUTS) and diabetes were evaluated by uroflowmetry, cistotonometry with electromyography and pressure flow study. Including criteria consisted of IPSS more than 8, PSA lower than 4, RT carcinoma excluded and prostate size more than 25 cm3. REZULTS: Patient age was 50 to 77 years. In two patients due to acute retention urinary catheter was inserted. Only they were treated with alfa blockers while other patients received no therapy. Four patient had insulin dependant diabetes while ten of them had diabetes regulated with oral antidiabetics. Cistotonometry presented detrusor overactivity in two patients, treated with M cholinergics. In one patient overactive detrusor activity was in the same time presented with urge incontinence and treated in the same way. Normal detrusor activity was recorded in 14 patients on pressure flow evaluation. In 8 patients with Q max more than 15 ml/s treatment was watchfull waiting. In 4 patients with Q max more than 12 ml/s alfa blockers were introduced. In 2 patients with Q max less than 10 ml/s bipolar TURP was the treatment.

Diabetes and diabetic bladder disfunction will have a great impact on quality of life due to an aging population. All specialities should be informed for diabetic bladder disfunction and necesssity for recognition and treatment. Further investigation is needed in terms of understanding the risk factors, mechanisms and the most adequate therapy.