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Thread: diabetic neuropathy pre/post or without SCI

  1. #1
    Senior Member Tom's Avatar
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    diabetic neuropathy pre/post or without SCI

    I have diabetic cystopathy, and although I haven't been evaluated for it, probably several other diabetic neuropathies (autonomic, peripheral, etc) as well. Indeed, that's how I found this website, through Googling on bladder management as I was having a lot of trouble at the time.

    It is somewhat ironic that several of my symptoms, most notably bladder and bowel issues are strikingly similar to SCI individuals, although the cause is very different.

    Did anyone here have similar symptoms as a result of diabetes before sustaining an SCI? Or if they've developed Type2 diabetes after an SCI (I understand that there is indeed an increased risk in the SCI population), how has it changed managing your health if any?

    I did a lot of research as you may have imagined, and it turns out that diabetes is one of the most common causes of neurogenic bladder, not because it is a common complication of diabetes per se, but that diabetes is such a common disorder. But ironically, urinary tract issues (retention, UTI's, other infections) are EXTREMELY common among diabetics.

    I'm just thinking surely I can't be the only one!

    Tom

  2. #2
    Tom,

    Welcome. The main difference between diabetic cystopathy and neurogenic bladder of spinal cord injury is the presence of spasticity.

    Wise.

    Quote Originally Posted by Tom
    I have diabetic cystopathy, and although I haven't been evaluated for it, probably several other diabetic neuropathies (autonomic, peripheral, etc) as well. Indeed, that's how I found this website, through Googling on bladder management as I was having a lot of trouble at the time.

    It is somewhat ironic that several of my symptoms, most notably bladder and bowel issues are strikingly similar to SCI individuals, although the cause is very different.

    Did anyone here have similar symptoms as a result of diabetes before sustaining an SCI? Or if they've developed Type2 diabetes after an SCI (I understand that there is indeed an increased risk in the SCI population), how has it changed managing your health if any?

    I did a lot of research as you may have imagined, and it turns out that diabetes is one of the most common causes of neurogenic bladder, not because it is a common complication of diabetes per se, but that diabetes is such a common disorder. But ironically, urinary tract issues (retention, UTI's, other infections) are EXTREMELY common among diabetics.

    I'm just thinking surely I can't be the only one!

    Tom

  3. #3
    Senior Member Tom's Avatar
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    Er, uhm....thanks for the welcome, Doc. Been here a couple years tho, but better late than never, right?

    I thought I'd bring this back up to the top, because you mentioned that spasticity is the main difference.

    To summarize, I've had IDDM Type 2 for about 10 years now, however my present bladder issues did not surface till late 2004, when I got a UTI which ended up becoming both ABP and pyelo. I was on Levaquin which resolved the kidney infection, but the prostate infection was missed and I suffered in great agony for weeks, until being hospitalized for low potassium. Then I relapsed and developed a large prostate abscess that required 2 procedures (drain, then TUIP 3 months later) to resolve. A urodynamics in early 2005 showed a very hypocontractile bladder, which is generally associated with diabetic cystopathy.

    But here's the intersting part. I DO indeed have spasticity - a LOT of it. I've been on Ditropan since last December, and every time I've run out, my bladder goes nuts. I can void somewhat better than I used to (which was hardly at all), but every time I void first and then cath afterwards, I have residual urine ranging from none to over 1 liter. Also, as a rule, the lower the volume the harder it is to get that damned catheter in past my upper sphincter.

    To further complicate matters, I have to take furosemide for fluid retention, and since I still can't tell how full my bladder is, I've had several occasions, mostly upon waking in the morning and a few hours after taking the Lasix where I've cathed in excess of 2300mL (yes, that's over 2 liters!). The only symptoms I have of such a hugely distended bladder is a feeling not unlike being kicked in the navel, and shortly thereafter my right kidney starts aching. So I try to avoid getting that full. But at the same time as I mentioned the lower my volume the harder it is to insert the catheter. Yes, I do know to keep gentle pressure against the sphincter till it relaxes. It rarely if ever works. Sometimes removing the cath, waiting a couple minutes and trying again works, other times I've simply had to rinse it in cold water (makes it stiffer) and try several times.

    So what I don't understand is, why so much spascticity I have to take 30mg of Ditropan a day yet so much retention? Espescially since its often in the morning, long after the previous dose of Ditropan has worn off and before (but not always) my morning dose? I've also had very large volumes several times (1500+) even after several days of not being on Ditropan.

    Could there be more than one process going on, and should I reconsider my current bladder management? It seems like the only thing that works is carrying a big urinal around, which is pointless, or a external condom cath, which I can't put on due to ED and not being able to reach my privates with both hands (particularly now that I have a bum right shoulder).

    Thanks in advance for any opinions and observations!

    Tom

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