A study of bladder dysfunction in women with type 2 diabetes mellitus.
A study of bladder dysfunction in women with type 2 diabetes mellitus.
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DOI：
10.4103/2230-8210.137518
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发表时间：
2014-07
影响因子：
--
通讯作者：
Priya S
中科院分区：
文献类型：
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作者：
Karoli R;Bhat S;Fatima J;Priya S
糖尿病与早期发病和严重程度增加的泌尿系统疾病相关，通常导致衰弱的泌尿系统并发症。糖尿病性膀胱功能障碍是指糖尿病患者发生的一系列膀胱症状，从膀胱过度活动到膀胱收缩功能受损。膀胱功能障碍在女性糖尿病患者中是一个被低估的问题。本研究旨在探讨2型糖尿病女性患者膀胱功能障碍的患病率及其与糖尿病其他慢性并发症的关系。在一项以医院为基础的横断面研究中，纳入了一组有下尿路症状（LUTS）的2型糖尿病妇女。我们使用美国泌尿协会症状指数（AUA-SI）评估LUTS的严重程度，使用独立急症严重程度量表（IUSS）评估膀胱过度活动（OAB）的存在。研究人员还研究了年龄bmi匹配的对照组，这些对照组没有糖尿病，但有下尿路症状，并与患有2型糖尿病的女性进行了比较。对有意愿的患者进行尿动力学评估。排除其他原因后，67%的2型糖尿病女性患者报告了由膀胱功能障碍引起的LUTS。其中36%为中度至重度LUTS （AUA-SI总评分为bb0.7）。OAB患病率为53%。尿动力学评估显示，48%的患者存在压力性尿失禁，23%和11%的患者出现逼尿肌过度活动和活动不足的变化。在糖尿病的慢性并发症中，周围神经病变、肾病和代谢综合征的存在与中重度LUTS和OAB显著相关。膀胱功能障碍是女性糖尿病患者中非常普遍的并发症。糖尿病的慢性并发症，特别是神经病变、肾病和代谢综合征的存在是膀胱功能障碍的重要预测因素。
Diabetes mellitus has been associated with an earlier onset and increased severity of urologic diseases that often result in debilitating urologic complications. Diabetic bladder dysfunction refers to a group of bladder symptoms occurring in patients with diabetes mellitus ranging from bladder over activity to impaired bladder contractility. Bladder dysfunction is an under evaluated issue in women with diabetes. Aim of our study was to investigate prevalence of bladder dysfunction and its relation with other chronic complications of diabetes in women with type 2 diabetes. In a hospital-based cross sectional study, a cohort of women with type 2 diabetes mellitus who had lower urinary tract symptoms (LUTS) were enrolled. We used the American Urological Association Symptom Index (AUA-SI) to assess the severity of LUTS and the Indevus Urgency Severity Scale (IUSS) to assess presence of overactive bladder (OAB). Age-BMI- matched controls that did not have diabetes but had lower urinary tract symptoms were also studied and compared with women with type 2 diabetes. Urodynamic evaluation was done in willing patients. LUTS attributable to bladder dysfunction were reported in 67% of women with type 2 diabetes after exclusion of other causes. Out of them, 36% had moderate to severe LUTS (total AUA-SI score >7). Prevalence of OAB was 53%. Urodynamic evaluation revealed presence of stress urinary incontinence in 48% patients and changes of detrusor over activity and detrusor under activity in 23% and 11% patients, respectively. Among the chronic complications of diabetes, peripheral neuropathy, nephropathy, and presence of metabolic syndrome were significantly associated with moderate to severe LUTS and OAB. Bladder dysfunction is a highly prevalent complication in women with diabetes. Chronic complications of diabetes especially neuropathy, nephropathy, and presence of metabolic syndrome are important predictors of bladder dysfunction.