A 50 year old man, known to have diabetes, presents with poor urinary stream, hesitancy, difficulty in micturation and failure to void completely. What is the diagnosis ?
Autonomic neuropathy Autonomic neuropathy is a group of symptoms that occur when there is damage to the nerves that manage every day body functions. These functions include blood pressure, hea rate, sweating, bowel and bladder emptying, and digestion. Causes Autonomic neuropathy is a group of symptoms. It is not a specific disease. There are many causes. Autonomic neuropathy involves damage to the nerves that carry information from the brain and spinal cord. The information is then carried to the hea, blood vessels, bladder, intestines, sweat glands, and pupils. Autonomic neuropathy may be seen with: Alcohol abuse Diabetes (diabetic neuropathy) Disorders involving scarring of tissues around the nerves Guillain Barre syndrome or other diseases that inflame nerves HIV/AIDS Inherited nerve disorders Multiple sclerosis Parkinson disease Spinal cord injury Surgery or injury involving the nerves Symptoms Signs and symptoms of autonomic neuropathy depend on the nerves affected. They might include: Dizziness and fainting when standing, caused by a sudden drop in blood pressure (ohostatic hypeension). Urinary problems, such as difficulty staing urination, incontinence, difficulty sensing a full bladder and inability to completely empty the bladder, which can lead to urinary tract infections. Sexual difficulties, including problems achieving or maintaining an erection (erectile dysfunction) or ejaculation problems in men. In women, problems include vaginal dryness, low libido and difficulty reaching orgasm. Difficulty digesting food, such as feeling full after a few bites of food, loss of appetite, diarrhea, constipation, abdominal bloating, nausea, vomiting, difficulty swallowing and heaburn, all due to changes in digestive function. Inability to recognize low blood sugar (hypoglycemia), because the warning signals, such as getting shaky, aren't there. Sweating abnormalities, such as sweating too much or too little, which affect the ability to regulate body temperature. Sluggish pupil reaction, making it difficult to adjust from light to dark and seeing well when driving at night. Exercise intolerance, which can occur if your hea rate stays the same instead of adjusting to your activity level. Ref:
BPH
Autonomic neuropathy
UTI
Atonic bladder
Urology