Comparison of Medical Therapeutic Efficacy in the Patinet with Diabetic Cystopathy According to Prevalence Period of Diabetes Mellitus

Shin, Yong Gyu; Park, Youg II; Cho, Sung Ryong

Abstract

PURPOSE
Patients with diabetic cystopathy ultimately undergo morphometric and functional changes in their bladder. Therefore, various voiding symptoms such as frequency, nocturia, urgency, hesitancy, retention and weak stream were evaluated. Irritative symptoms usually develop in cases where the prevalence period of diabetes mellitus (DM) is short, and the obstructive symptoms develop in the opposite case. Improving the voiding symptoms might differ according to prevalence period. Therefore, the therapeutic efficacy of the treatment was compared.
MATERIALS AND METHODS
One hundred ten patients were divided into three groups according to how long they had suffered from DM, and were treated with medical therapy over a 4 week period: group A (<5yrs), group B (5-10yrs), group C (>10yrs). The patients were asked to write their subjective symptoms in a voiding diary and a urodynamic study was undertaken.
RESULTS
After medical therapy, the frequency, nocturia and urgency in group A had improved to 72%, 77% and 88% respectively (p<0.05). The frequency, nocturia, urgency, hesitancy, retention and weak stream in group B had improved to 51%, 57%, 66%, 59%, 69% and 61% respectively (p<0.05), and in group C these symptoms had improved to 15%, 12%, 10%, 17%, 12% and 8% respectively (p>0.05). In a urodynamic study of group B, the maximum detrusor pressure had increased from 20.3+/-6.7cmH2O to 53.5+/-8.1cmH2O and the post void residuals decreased from 62.3+/-36.4ml to 21.2+/-17.1ml (p<0.05). In addition, there were little improvements in the maximum bladder capacity, the first sensation and compliance (p>0.05). In group C, there was little improvement in the urodynamic study (p>0.05).
CONCLUSIONS
The medical therapeutic efficacy for these patients reduces as the DM revalence period is longer.