Detection of neurogenic erectile dysfunction in diabetic patients with Uroflowmetry
1: , Serbia and Montenegro
Objectives: Aim was to estimate which of uroflowmetric parameters significantly correlate with neurogenic detrusor insufficiency and neurogenic erectile dysfunction in diabetics.
Design and Methods: 94 pts with diabetes mellitus (DM) were included in study ( cross sectional study ). Mean age of the pts were 53±13yrs, SD (range:23-77). The average duration of DM was 9,88± 6,95yrs, SD (range:0,2-31). The patients were divided due to severity of diabetic cystopathy (DC) and lower urinary tract symptoms. 43 pts suffered from incipient DC and had subclinical presentation of autonomic neuropathy, while 51 pts were with prominent DC( RU over 20% of bladder capacity, severely damaged sensibility, hypo or acontractile detrusor) and clinical presentation of autonomic neuropathy. All uroflowmetric parameters were determined during spontaneous uroflowmetry and pressure-flow-EMG study. As for ED the thorough interview with the pts was carried out, as well as laboratory analysis, penodynamic test, Duplex Doppler ultrasonography, EMG of lower extremities, Ewing-Clark test.
Results : Out of 43 pts in the first group 23 (53,47%) had neurogenic and/or neurogenic-vasculogenic ED, while in the second group out of 51 pts, 49 (96,08%) had neurogenic and neurogenic/vasculogenic ED ( p=0.002). In the second group periferic neuropathy was more often recorded (p=0.008), also earlier onset of DM(0.001), as well as longer duration of DM (p=0.009). Voiding time and time to Qmax was significantly longer in the group of pts with more prominent DC (p=0.03). Voidng volume and PVR was significantly bigger in second group.
Conclusions: Uroflowmetry is simple, non-invasive method of urine flow testing i.e. establishing the existence of detrusor insufficiency or subvesical obstruction, but as well, secondary way, of autonomous penile neuropathy.
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