Urinary Bladder Disturbances in Diabetics: I. A Comparative Study of Male Diabetics and Controls Aged between 20 and 50 Years

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Abstract
In order to establish the frequency of urinary bladder disturbances in diabetics and to attempt to obtain support for the view that these bladder disturbances are neurogenic, 30 male diabetic's clinical data were analysed and correlated to the findings of cystometry, micturition urethrocystography and pelvic floor electro-myography. A control series of 25 healthy men was studied with the same methods. 5 of 30 diabetics had micturition difficulties. Impotence and/or ejaculatory disturbances were present in 8 cases. On cystometry, some 50 per cent of the diabetics had a bladder capacity in excess of 600 ml and a hypotonic cystometric curve. Micturition urethrocystography demonstrated “large bladders” in roughly 50 per cent of the diabetics, but also a number of instances of faulty widening of the internal sphincter, hypotonic bladder shape, or signs of infection. Micturition urethrocystography demonstrated pathologic findings in altogether 65 per cent of the diabetics. Electromyography showed an increased potential duration in the striated urethral sphincter, the striated anal sphincter and the levator ani. No signs of peripheral neuronal damage or myopathy were detected. No fully proven correlation between the bladder disturbances and the duration and other manifestations of the disease was demonstrable. However, 10 of seventeen patients with “large bladders” had signs of peripheral neuropathy, while 7 had no such signs. Vascular damage was present in 7 of the first group and in 5 of the second group. The present investigation affords no evidence that the urinary bladder disturbances in the diabetics resulted from neurogenic damage.