Investigating the Prevalence of Autonomic Neuropathy in Diabetic Patients with Urinary Irritation Symptoms Without a Known Cause
Urology Journal,
Vol. 21 No. 06 (2024),
27 November 2024
,
Page 420-424
https://doi.org/10.22037/uj.v21i.8222
Abstract
Purpose: Evaluating pseudomotor performance can be a valuable tool for investigating the peripheral autonomic
nervous system in diabetic patients. Sudoscan, a simple and non-invasive method for assessing pseudomotor
performance, has been developed in recent years. This study aimed to investigate autonomic neuropathy using
Sudoscan in diabetic patients with lower urinary tract symptoms (LUTS) of unknown cause.
Materials and Methods: In this cross-sectional study conducted from April 2022 to April 2023, we included 195
patients with type 2 diabetes who were referred to the urology clinic. We extracted demographic, clinical, and
laboratory data from the patient files and evaluated urinary symptoms using the International Prostate Symptom
Score (IPSS) questionnaire. Patients underwent Sudoscan testing to evaluate autonomic neuropathy in the physical
medicine and rehabilitation clinic. To further assess urinary irritative symptoms, patients underwent urodynamic
studies (UDS) and ultrasonography.
Results: The Sudoscan test results showed that autonomic neuropathy was present in 77 patients (40%), with 43
(22.1%) having moderate and 44 (22.6%) having severe neuropathy. Patients with autonomic neuropathy were
found to be older, had longer diabetes durations, higher average blood glucose levels, and higher creatinine levels.
Additionally, we found a significant correlation between autonomic neuropathy and signs of high post-void residue
on ultrasound and detrusor contraction disorders on UDS (p-value < 0.05).
Conclusion: Our study found a higher prevalence of autonomic neuropathy in diabetic patients with LUTS using
Sudoscan (40%). Longer diabetes duration and poor glycemic control were associated with an increased risk of
autonomic neuropathy linked with LUTS, such as urge incontinence.
- Autonomic Neuropathy
- Lower Urinary Tract Symptoms
- Sudoscan
- Type 2 diabetes
How to Cite
References
Casellini CM, Parson HK, Richardson MS, Nevoret ML, Vinik AI. Sudoscan, a noninvasive tool for detecting diabetic small fiber neuropathy and autonomic dysfunction. Diabetes Technol Ther. 2013;15:948-53.
Luk AO, Fu W-C, Li X, et al. The clinical utility of SUDOSCAN in chronic kidney disease in Chinese patients with type 2 diabetes. PLoS One. 2015;10:e0134981.
Pop-Busui R, Hotaling J, Braffett BH, et al. Cardiovascular autonomic neuropathy, erectile dysfunction and lower urinary tract symptoms in men with type 1 diabetes: findings from the DCCT/EDIC. J Urol. 2015;193:2045-51.
Smith AG, Lessard M, Reyna S, Doudova M, Singleton JR. The diagnostic utility of Sudoscan for distal symmetric peripheral neuropathy. J Diabetes Complications. 2014;28:511-6.
Finazzi-Agro E, Gammie A, Kessler TM, et al. Urodynamics useless in female stress urinary incontinence? Time for some sense—a European expert consensus. Eur Urol Focus. 2020;6:137-45.
Ansari SH, Mahdy AE. Are video-urodynamics superior to traditional urodynamic studies in changing treatment decision with urinary symptoms? Arab J Urol. 2019;17:160-5.
Mayaudon H, Miloche P-O, Bauduceau B. A new simple method for assessing sudomotor function: relevance in type 2 diabetes. Diabetes Metab. 2010;36:450-4.
Gin H, Baudoin R, Raffaitin C, Rigalleau V, Gonzalez C. Non-invasive and quantitative assessment of sudomotor function for peripheral diabetic neuropathy evaluation. Diabetes Metab. 2011;37:527-32.
Hubert D, Brunswick P, Calvet J-H, Dusser D, Fajac I. Abnormal electrochemical skin conductance in cystic fibrosis. J Cyst Fibros. 2011;10:15-20.
Franceschi R, Mozzillo E, Di Candia F, et al. A systematic review of the prevalence, risk factors and screening tools for autonomic and diabetic peripheral neuropathy in children, adolescents and young adults with type 1 diabetes. Acta Diabetol. 2022;59:293-308.
Kouidrat Y, Pizzol D, Cosco T, et al. High prevalence of erectile dysfunction in diabetes: a systematic review and meta‐analysis of 145 studies. Diabet Med. 2017;34:1185-92.
Selvarajah D, Cash T, Davies J, et al. SUDOSCAN: a simple, rapid, and objective method with potential for screening for diabetic peripheral neuropathy. PLoS One. 2015;10:e0138224.
Ozaki R, Cheung KK, Wu E, et al. A new tool to detect kidney disease in Chinese type 2 diabetes patients: comparison of EZSCAN with standard screening methods. Diabetes Technol Ther. 2011;13:937-43.
Freedman BI, Bowden DW, Smith SC, Xu J, Divers J. Relationships between electrochemical skin conductance and kidney disease in type 2 diabetes. J Diabetes Complications. 2014;28:56-60.
Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003;26:1553-79.
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