Surface electromyography in the diagnosis of urogenital form of diabetic autonomic neuropathy in female patients with type 1 diabetes mellitus

摘要

Background. The aim of the study is to evaluate the effectiveness of non-invasive research methods in the diagnosis of urinary disorders in patients with type 1 diabetes mellitus (DM). Materials and methods. In this work, we have examined 184 female patients with type 1 DM complicated by urogenital form of diabetic autonomic neuropathy and urinary disorders using non-invasive methods. These methods include surface electromyography and ultrasound of the bladder. Results. It is established that the study of the contractile ability of the pelvic floor muscles and the sphincter apparatus of the urethra makes it possible to determine the clinical form of urinary disorders. The study of the contractile ability of the pelvic floor muscles and the urethral sphincter apparatus allows, in addition to the results of the questionnaire scale in diabetes, to determine the possible clinical form of urinary disorders in patients with type 1 DM. The parameters of surface electromyography vary depending on the clinical form of urination disorders. In urinary retention, there is an increase in the muscle tone of the urogenital zone as a consequence of the formation of the phenomenon of denervation hypersensitivity. Conclusions. Urinary incontinence is accompanied by diffuse demyelination of sensory and motor nerve trunks, with a coarse axonal component as a result of increased vegetative-trophic disturbances of the muscular apparatus of the urogenital zone. The amount of residual urine, which is determined by ultrasound, in patients with retention grows with an increase in the degree of impaired urination.