Background. The aim of the study is to evaluate the effectiveness of non-invasive research methods in the diagnosis of urinary disorders in patients with type 1 diabetes mellitus (DM). Materials and methods. In this work, we have examined 184 female patients with type 1 DM complicated by urogenital form of diabetic autonomic neuropathy and urinary disorders using non-invasive methods. These methods include surface electromyography and ultrasound of the bladder. Results. It is established that the study of the contractile ability of the pelvic floor muscles and the sphincter apparatus of the urethra makes it possible to determine the clinical form of urinary disorders. The study of the contractile ability of the pelvic floor muscles and the urethral sphincter apparatus allows, in addition to the results of the questionnaire scale in diabetes, to determine the possible clinical form of urinary disorders in patients with type 1 DM. The parameters of surface electromyography vary depending on the clinical form of urination disorders. In urinary retention, there is an increase in the muscle tone of the urogenital zone as a consequence of the formation of the phenomenon of denervation hypersensitivity. Conclusions. Urinary incontinence is accompanied by diffuse demyelination of sensory and motor nerve trunks, with a coarse axonal component as a result of increased vegetative-trophic disturbances of the muscular apparatus of the urogenital zone. The amount of residual urine, which is determined by ultrasound, in patients with retention grows with an increase in the degree of impaired urination.
diabetes mellitus; neuropathy; urogenital form; urinary disorders; surface electromyography
International Diabetes Federation. Available at: httpː//www.idf.org.
Dedov II, Melnichenko GA, editors. Jendokrinologija. Nacional'noe rukovodstvo [Endocrinology: national guidebook]. Мoscow: GEOTAR-Media; 2008. 1072p. (in Russian).
Zabarovskaya ZV, Shyshko EI, Zabarovskaya OV. A place of benphothiamin in treatment of late complications of diabetes mellitus. Lechebnoye delo. 2013;5(33):13-17. (in Russian).
Borodina VI, Zamiatina OV, Povarova OYu, Sukhacheva AP, Borodina MA. Saharnyj diabet. Klinika, diagnostika, pozdnie oslozhnenija, saharosnizhajushhaja i metabolicheskaja terapija [Diabetes mellitus. Clinical data, diagnostics, late complications, hypoglycaemic and metabolic therapy]. Мoscow: Medpraktika; 2009. 60p. (in Russian).
Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature. 2001;414(6865):813-820. PMID: 11742414. doi: 10.1038/414813a.
Kempler P. Autonomic neuropathyː a marker of cardiovascular risk. Br J Diabetes Vasc Dis. 2003;3(2):84-90. doi: 10.1177/14746514030030020201.
Marshal de Calvi Ch-J. Recherches sur les accidents diabétiques et essai d’une théorie générale de diabète. Asselin und Labe; 1864. 658p.
Kotov SV, Kalinin AP, Rudakov IG. Diabeticheskaja nejropatija [Diabetic neuropathy]. Moscow: Meditsina; 2000. 150p. (in Russian).
Vein AM. Vegetativnye rasstrojstva [Vegetative disorders]. Мoscow: Medicinskoe informacionnoe agentstvo; 2001. 390p. (in Russian).
Aliaev YG, Grigorian VA, Gadjieva ZK. Rasstrojstva mocheispuskanija [Disorders of urination]. Мoscow: Literatura; 2006. 208p. (in Russian).
Pirogov VA. Methods of diagnostics and treatment of hyperactive urinary bladder. Meditsinskiye aspekty zdorovia zhenshchiny. 2009;8(25):25-27. (in Russian).
Haikina EV, Reshed’ko GK, Morozov MV. Infections of urinary ways in diabetic patients. Klinicheskaya mikrobiologia i antimikrobnaya himioterapiya. 2008;3(3):36-44. (in Russian).
Tkachuk EY, Kravchun NA. Clinical diagnostics of urination violations in diabetic patients. Problemy endokrynnoi patologii. 2016:2:47-53. (in Russian).
Glazer HI, Rodke G, Swensionis C, et al. Treatment of Vulval Vestibulitis Syndrome wich Electromyographic Biofeedback of Pelvic Floor Musculature. J Reprod Med. 1995;40(4):283-90. PMID: 7623358.