Evaluation Of Abnormalities Of Urinary Bladder In Female Patients Of Type 2 Diabetes Mellitus By Ultrasonography

Objective:It is well known that one of the most common complications of type 2 diabetes mellitus(T2DM)is certainly the lower urinary tract complications.And among lower urinary tract complications,diabetic cystopathy is the most frequent occurrence.Diabetic cystopathy,mainly includes the symptoms like polyuria,urinary retention and incontinence.But diabetic cystopathy,which leads to a huge decline in living standards and qualities among diabetic patients,usually fails to draw enough attention to make a difference from both clinical physicians and diabetic patients.DM is influential in changing the neuron system,smooth muscle and urothelium due to polyuria and oxidative stress mechanism.The complex interactions between the changes of the neuron system,smooth muscle and urothelium eventually affect bladder structure and functions.To evaluate the abnormalities of urinary bladder in the female patients of type 2 diabetes mellitus by ultrasonography and discuss its clinical value.Methods:The data gathering procedure Is from September of 2014 to April of 2015.Totally 60 female patients with T2 DM excepted smoking,history of surgery,and neurological disorders(Parkinson’s disease and spinal cord injury,etc.)were divided into two groups accroding to the diabetic durations: group A(diabetic duration>10 years)and group B(diabetic duration≤10 years;each n=30).Thirty healthy subjects were involved as group C.The patients with the pubic region revealed were examined in supine position,using a convex array ultrasonic probe(3~5 MHz)to measure the left and right diameter,the upper and lower diameter,the front and rear diameter of bladder.When the bladder capacity was more than 250 ml,the detrusor wall thickness(DWT)and bladder wall thickness(BWT)of urinary bladder was measured by high-frequency ultrasonography(7.5 MHz).Ultimately three internal diameters of bladder were measured after bladder was empty.The postvoid residual volume(PRV)and ultrasound estimated bladder weight(UEBW)was calculated.The three groups of DWT,UEBW and PRV were analyzed statistically.Results:As adequate filling of the bladder,the bladder is round or oval in cross section of the ultrasound image and shows round blunt triangle in the longitudinal section.The urine in the bladder is anechoic area.When bladder is empty,the surface is not smooth.The apex of the bladder does not exceed the upper margin of symphysis ossium pubis.Under diagnostic ultrasound images,the detrusors are shown to be a hypoechoic area,while the mucous membranes,the submucosal tissues and membranae serosa are hyperechoic areas,respectively representing the interface echoes between mucous membranes and urine,and the boundary between membranae serosa and its surrounding tissues.The DWT of urinary bladder of group A was significantly higher than those of group B and group C(all P<0.05).The UEBW of group A and group B were higher than that of group C and so was it with group A and group B(all P<0.05).There was no significant difference in the PRV of bladder among the three groups(allP>0.05).Conclusion:As for diabetic women,the measurements of detrusor thickness and bladder weight by Ultrasonography in clinical follow-up visits are beneficial in monitoring the early-stage bladder structural changes.The abnormalities of urinary bladder in the female patients can be evaluated acutely and non-invasively by ultrasonography,which has an important clinical value in the early diagnosis,slowing the progression and improving the prognosis of diabetic cystopathy in the female type 2 diabetic patients.