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ORIGINAL ARTICLE
Year : 2013  |  Volume : 40  |  Issue : 1  |  Page : 39-49

Evaluation of different electrophysiological studies in the detection of urinary and sexual dysfunction in diabetic women


1 Department of Rheumatology and Physical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Department of Urology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Hanan El Sebaie El Hefnawy
MD, Department of Rheumatology and Physical Medicine, Faculty of Medicine, Ain Shams University, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


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Background Diabetes mellitus is the most common cause of urinary and sexual dysfunction. Although diabetes mellitus can be diagnosed clearly and simply, diabetic neuropathy and diabetic cystopathy (DC) can progress insidiously over time without any symptoms, manifesting itself at a later stage, which increases the risk of secondary complications. Therefore, early diagnosis in the asymptomatic stage of DC with a simple noninvasive method is of utmost importance. Aim of the work To evaluate the different electrophysiological studies [including genital sympathetic skin response (SSR), somatosensory-evoked potential (SSEP) of the tibial nerve] in the early detection of urinary and sexual dysfunction in diabetic women. Patients and methods This study was carried out on 30 diabetic women and 10 healthy women served as a control group. All patients were divided into two groups (group I and group II) with respect to lower urinary tract symptoms and signs. They were subjected to a full assessment of medical history, full neurological examination, and assessment by the female sexual function index questionnaire. Urodynamic studies including: uroflowmetry and cystometry were carried out for all patients. Electrophysiological studies were carried out for both patients and controls and included nerve conduction studies of both tibial and peroneal nerves, sensory nerve conduction studies of both sural nerves, SSEP of the tibial nerve and genital, hand, and foot SSR. Results In group I: Abnormal findings of motor studies were recorded in 1/15 (6.6%) patients, prolonged genital SSR in one patient (6.6%) and absent in two patients 2/15 (13.3%). Prolonged SSEP were recorded in 2/15 (13.3%) of patients. As regards urodynamic study, abnormal findings were detected in 3 patients (20%). In group II: Abnormal findings of motor studies were recorded in 8/15 (53.3%) patients, absent foot SSR in four patients (26.6%), absent genital SSR in seven (46.6%) patients. Prolonged SSEP P40 were recorded in 6/15 (40%). As regards urodynamic study, abnormal findings were detected in 12 patients (80%). There was statistically significant difference between both groups as regards all electerophysiologic parameters except foot latency. There was a statistically highly significant difference between urodynamic diagnosis and genital SSR and SSEP P40 of tibial nerve. Conclusion Although urodynamic is essential for the actual diagnosis and the detection of variable pathophysiological changes, electrophysiological studies represent an easy, valid, and noninvasive objective method for the evaluation of DC and sexual dysfunction.


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