EXPERIMENTAL STUDY ON THE NEUROGENIC BALDDER
X. EXPERIMENTAL STUDIES ON THE DYSFUNCTION OF THE URINARY BALDDER DUE TO DIABETES MELLITUS (2)
1965 Volume 56 Issue 3 Pages 269-288
Details
1965 Volume 56 Issue 3 Pages 269-288
The dysfunction of urinary bladder which appears during cource of diabetes mellitus has been a subject of investigations. Many reports have been issued on clinical features of the dysfunction, but the pathogenesis still has remained unexplained in many respects. In order to clarify it, following study was performed.
In 20 of 43 mongrel dogs with alloxan diabetes of 7-300 days' durtaion, histologic examination was done on the nerves innervating to the bladder: the posterior and anterior roots of the lunbar nerves I-IV, posterior and anterior roots of the sacral nerves I-III, hypogastric nerves and pelvic nerves. The results are summarrized as follows:
1) Wide-spread, bilateral demyelination was noted in the myelinated fivers in all the above mentioned nerves.
2) Commonest sites of demyelination were the roots of the spinal nerves, especially in the sacral nerves. The degeneration was more pronounced in the posterior roots than in the anterior roots.
3) The demyelination was most frequently found in the small-sized fibers and less frequently in the medium-sized. None was found in the large-sized fibers.
It follows from this findings that finer nerve fibers are more susceptible to the diabetic changes than the large-sized. Finer nerve fibers are affected in the early stage of the disease, while the large-sized fibers may be involved slowly with gradual occurrence of the degeneration in the later stage.
4) Abnormal cystometrograms were obtained in 5 dogs; hypotonic curve in 4 dogs and autonomous curve in 1 dog. In all these dogs, presence of degeneration in myelinated fibers in the pelvic and hypogastric nerves was cnfirmed. From this finding it follows that demyelination of nerve fibers can be closely related with appearence of the vesical dysfunction seen in the diabetic dogs.
From these findings it can be assumed that dysfunction of the urinary bladder which appears during course of diabetes mellitus will be of neurogenic origin and that it should be called as “Diabetic Neurogenic Bladder.”
