Abstract
A 42-year-old man with uncontrolled NIDDM of 10years duration was admitted to our hospital. His presenting complaints were fatiguability and micturitional disturbance. Biochemical examination revealed elevated levels of fasting plasma glucose and HbA1c. Fundoscopy showed Scott IIIa retinopathy. Findings of decreased deep tendon reflexes, reduced nerve conduction velocity and a small R-R coefficient of variation intervals on ECG indicated progression of both peripheral and autonomic neuropathy. In the urodynamic study, although the volume of residual urine was 25ml, cystometry showed a hypotonic hypoactive bladder. Uroflowmetry revealed a low flow rate of urine. Thus, diabetic neurogenic bladder was thought to be the cause of his micturitional disturbance. An α1-adrenergic blocking agent, bunazocin hydrochloride, was administered at a daily dose of 3mg. During the α1-adrenergic blocker treatment, his micturitional disturbance disappeared completely. Furthermore, uroflowmetry showed a marked improvement in the urinary flow rate. In conclusion, α1-adrenergic blocker was demonstrated to be a useful agent for treatment of diabetic neurogenic bladder.
