January 1991

Importance of Complete Cytometric Evaluation of Vesical Dysfunction in Elderly Diabetic Patients

Author Affiliations

New Hyde Park, NY

Arch Intern Med. 1991;151(1):201-202. doi:10.1001/archinte.1991.00400010181037

To the Editor.—  This is in response to the article by Starer and Libow1 entitled "Cystometric Evaluation of Bladder Dysfunction in Elderly Diabetic Patients" that appeared in the April 1990 issue of the ARCHIVES. The authors state that an elderly patient with symptoms of urinary incontinence must be properly evaluated in order to select the appropriate treatment for the urinary incontinence, and we agree with that wholeheartedly. However, they go on to state in the abstract that 61% of their population of elderly diabetic patients were documented to have involuntary contractions of the bladder, and the underlying cause of incontinence in this population was urinary retention secondary to autonomic neuropathy. We feel that this is a partial description of the problem of the diabetic patients with symptoms of urinary incontinence.Diabetic vesical dysfunction is principally the result of segmental demyelination in the peripheral nerve supply to the detrusor muscle

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