[The impact of mellitus diabetes on the lower urinary tract: A review of Neuro-urology Committee of the French Association of Urology]

Specify urinary functional impairment associated with diabetic pathology. Propose guidance for screening, monitoring of clinical signs of lower urinary tract (LUTS) and describe the specifics of the urological treatment of patients.

A review of literature using PubMed library was performed using the following keywords alone or in combination: "diabetes mellitus", "diabetic cystopathy", "overactive bladder", "bladder dysfunction", "urodynamics", "nocturia".

LUTS are more common in the diabetic population with an estimated prevalence between 37 and 70 %, and are probably underevaluated in routine practice. They are heterogeneous and are frequently associated with other diabetic complications. Both storage and voiding symptoms can coexist. Despite a major evaluation in the literature, no recommendation supervises the assessment and management of LUTS in this specific population. An annual screening including medical history, bladder and kidney ultrasound and post-void residual measurement is required in the follow-up of diabetic patients. Specific urologial referral and urodynamic investigations will be performed according to the findings of first-line investigations. The type of bladder dysfunction, the risk of urinary tract infections and dysautonomia should be considered in the specific urological management of these patients.

Diabetes mellitus significantly impacts on the lower urinary tract function. A screening of LUTS is required as well as other complications of diabetes. The management of LUTS must take into consideration the specific risks of the diabetic patient regarding the loss of bladder contractility, the possibility of dysautonomia and infectious complications.

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2015 Oct 06 [Epub ahead of print]

G Capon, R Caremel, M de Sèze, A Even, S Fontaine, C-M Loche, S Bart, E Castel-Lacanal, F Duchêne, G Karsenty, P Mouracade, M-A Perrouin-Verbe, V Phé, D Rey, M-C Scheiber-Nogueira, X Gamé

Service d'urologie, hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France. Service d'urologie, hôpital Charles-Nicolle, 76000 Rouen, France. , Cabinet de neuro-urologie, urodynamique et pelvipérinéologie, clinique Saint-Augustin, 33000 Bordeaux, France. , Service de médecine physique et réadaptation, hôpital Raymond-Poincaré, AP-HP, 92340 Garches, France. , Service de médecine interne, endocrinologie, diabète, nutrition, hôpital Joseph-Ducuing, 31300 Toulouse, France. , Service de rééducation neurolocomotrice, CHU Henri-Mondor, AP-HP, 94010 Créteil, France. , Service d'urologie, centre hospitalier René-Dubos, 95300 Cergy-Pontoise, France. , Service de médecine physique et réadaptation, CHU Rangueil, 31400 Toulouse, France. , Service d'urologie, clinique de l'Alliance, 37540 Saint-Cyr-sur-Loire, France. , Service d'urologie et de transplantation rénale, hôpital de la Conception, AP-HM, Aix-Marseille université, 13005 Marseille, France. , Service d'urologie, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France. , Service d'urologie, hôpital de la Cavale-Blanche, CHU de Brest, 29609 Brest, France. , Service d'urologie, hôpital de la Pitié-Salpêtrière, AP-HP, université Paris VI, 75013 Paris, France. , Clinique Saint-Augustin, 33000 Bordeaux, France. , Services d'urologie et d'explorations neurologiques, CHU Lyon Sud, 69495 Pierre-Bénite, France. , Service d'urologie, CHU Rangueil, 31400 Toulouse, France.