Urodynamic evaluation in simultaneous insulin-dependent diabetes mellitus and end stage rental disease

Purpose: We evaluated the urodynamic changes produced by insulin-dependent diabetes mellitus with end stage renal disease, Materials and Methods: A urodynamic evaluation was performed on 51 young patients (mean age plus or minus standard deviation 35 +/- 6 years) with long-term diabetes mellitus (average 21 +/- 6 years) and end stage renal disease (86% on dialysis). Results: The urodynamic study was abnormal in 84% of the patients. The bladder was hypersensitive in 39% and hyposensitive in 30% of the cases, and maximum vesical capacity was greater than 600 mi. in 33%. An acontractile detrusor was noted in 6% of the patients, while 4% had detrusor hyperreflexia and 35% had bladder outlet obstruction. Conclusions: A high frequency of vesical alterations was observed, which were modified by association of progressive vesical dysfunction and diabetes mellitus. In diabetes mellitus dialysis protects against detrusor hypocontractility but predisposes the patients to have bladder obstruction.