Urodynamic And Basic Research Of Diabetic Bladder Dysfunction

Aims1. Observe the urodynamic changes of diabetic patients in order to find possible diagnosis basis for diabetic bladder dysfunction, investigate the influence of diabetes to bladder.2. To assess the changes of nerve growth factors (NGF) in bladders of STZ-induced diabetic rats.Materials and Methods1.28female diabetic patients compared to28urodynamic-normal female people, observe their Maximum flow rate(Qmax), Voided volume, First desire to void, Maximum bladder pressure, Maximum detrusor pressure, Maximum cystometric capacity, Residual volume.2. Female Wistar(30) rats were divided into three equal groups:group Ⅰ, normal rats (NR); group Ⅱ,4-week STZ-diabetic rats (DR4); group Ⅲ,8-week STZ-diabetic rats (DR8). Bladder NGF was measured by Enzyme-linked immunosorbent assay (ELISA).Results1. The maximum urinary flow rate of diabetic group is10.4±7.6ml/s, significantly lower than that of control group21.4±4.1ml/s, the difference between the two groups was statistically significant (P<0.01). The residual urine volume of diabetic group was223.8±247.8ml, which was higher than that of the control group19.0±11.3ml, the difference between the two groups was statistically significant (P<0.01).The first desire to void of diabetic group was286.1±157.9ml, which was higher than that of the control group195.6±71.4ml, the difference between the two groups was statistically significant (P<0.05). The maximum detrusor pressure of diabetic and control group were20.6±19.1cmH20and30.8±11.1cmH2O, the maximum bladder capacity of diabetic group and the control group were514.3±163.2ml and320.9±90.3ml, two groups had significant difference (P<0.05). Diabetic cystopathy16cases (47.1%), detrusor overactive5cases (17.9%), bladder outlet obstruction3cases (10.7%),4cases (14.3%) detrusor contractility is normal.2. NGF in normal group was98.52±12.76pg/ug protein,4-week diabetic group was85.31±9.18pg/ug protein,4-week diabetic group was54.25±7.67pg/ug protein. The protein level of NGF in diabetic rats shows a gradual decrease compared to normal rats (p<0.05). Conclusions1. Diabetes mellitus could markedly decrease the Maximum flow rate and Maximum detrusor pressure while increase the bladder volume and the residual volume.2. Diabetes mellitus leads to down regulation of mature NGF which may play an important role in the course of diabetic bladder dysfunction.