Diabetic Neurogenic Vesical Dysfunction

A LTHOUGH bladder involvement in diabetes was alluded to over 100 years ago¹and established as a diabetic neuropathic manifestation 30 years ago,²it still remains a comparatively obscure clinical entity. The lack of appreciation of its relative frequency, the unfamiliarity with its clinical picture, the urgent indication for available remedial therapy, and the dire consequences of neglect prompt this paper. Our series consists of 27 cases collected within a relatively short period of time and is the largest such series to be reported. Terminology. —The term neurogenic vesical dysfunction describes the pathogenesis of the clinical syndrome in diabetes and should replace the term "chord bladder" which includes many pathologically and clinically unrelated entities.³ Clinical Picture. —The outstanding feature is the insidious nature of onset and progresssion of the bladder paralysis and urinary retention. The interval between voidings gradually increases until urine is passed only once or