EXPERIMENTAL STUDY ON THE NEUROGENIC BLADDER
IX EXPERIMENTAL STUDY ON THE DYSFUNCTION OF THE URINARY BLADDER DUE TO DIABETES MELLITUS (I)
1964 Volume 55 Issue 10 Pages 1049-1061
Details
1964 Volume 55 Issue 10 Pages 1049-1061
The present study was designed to clear the pathogenesis of diabetic neurogenic bladder. The cystometric observations of the urinary bladder as well as histologic examination of Langerhans' island of the pancreas and blood sugar tests were done in the dogs in which experimental diabetes was developed.
1) Severe diabetic condition of long duration developed in dogs with intravenous injection of alloxan at a dose of 60-70mg/kg. The blood sugar level increased slightly within several hours, and then, after slight decrease, it increased markedly with positive urine sugar test in 24 hours. In 48 hours typical symptoms of diabetes mellitus appeared with higher blood sugar level. Thus, a triphasic blood sugar curve was obtained.
2) Regressive changes were pronunced in the islands of Langerhans, particularly in β-cells. With administration of alloxan, α-cells increased slightly in number, while β-cells decreased rapidly to 1/8 of the normal number. With lapse of time β-cells showed a gradual regeneration.
3) In several dogs abnormal findings were noted on the cystometrogram over 43 days after the onset of severe diabetes. In majority of the cases the cystometrogram showed a low pressure curve, with either absence of spike of the first sensation to void or delay in it's occurrence. A marked increase in the bladder capacity and decreased intravesical pressure were also noted on the beginning of voiding. From this finding it is assumed that the vesical dysfunction may have a close relationship between the severity of diabetic condition and the duration of it.
4) Cystometrograms obtained were very similar to those in dogs in which either posterior roots or both posterior and anterior roots of the sacral nerves were cut off, or to those seen in tabes dorsalis. From this finding it is assumed that in the diabetic neurogenic bladder there could be some lesions found in the peripheral nerves innervated to the bladder or in the spinal cord, and that the lesions could play an important role in developing the vesical dysfunction.
