The current paradigm of diabetic cystopathy in Mexico
REVIEW ARTICLE
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v81i2.678Keywords:
Diabetic cystopathy, urodynamics, voiding reflex, obstructive symptoms, urinary symptoms, cystopathy treatment,Abstract
The term diabetic cystopathy describes the increase in bladder capacity and post-void residual volumes in diabetic patients, accompanied by decreased bladder sensation and contraction, attributed to diabetic neuropathy. Diabetic cystopathy is mainly one originated by a neuropathy, of sensory and autonomic origin due to the alterations suffered in the nerve fibers; in this article we will review the multiple theories about physiopathology. Patients present with an insidious symptomatology and when it is detectable is in an advanced stage, the main symptom is urinary incontinence. Its diagnosis is established through clinical presentation associated with neurological symptoms and confirmed by urodynamic studies. Strict control and adherence to DM2 treatment is the cornerstone to avoid long-term complications, including "Diabetic Cystopathy". If the disease is already established, pharmacological treatment is indicated, with a wide range of drugs to choose from; if it is not a candidate for pharmacological therapy or has severe symptoms, surgical management is possible with several surgical options such as bladder denervation or myomectomy.
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