1/9. A case of nephrogenic diabetes insipidus caused by obstructive uropathy due to prostate cancer.Nephrogenic diabetes insipidus (DI) secondary to chronic urinary tract obstruction is a rare disease. The exact cause is unknown but it is likely that increased collecting duct pressures cause damage to the tubular epithelium, resulting in insensitivity to the action of arginine-vasopressin (AVP). A 77-year-old man complaining of polyuria and polydipsia was treated with alpha glucosidase inhibitor under the impression of polyuria due to diabetes mellitus. But his symptoms did not improve. water deprivation and AVP administration study revealed that the patient had nephrogenic DI. urinary tract obstruction due to an enlarged prostate was suggested as a principal cause of nephrogenic DI. The patient underwent transurethral resection of the prostate and bilateral subcapsular orchiectomy. After surgery, the urine osmolarity was normalized and the patient became symptom-free. We report a case of nephrogenic DI due to obstructive uropathy which was cured by surgery eliminating obstruction.- - - - - - - - - - ranking = 1keywords = diabetes insipidus, insipidus, diabetes (Clic here for more details about this article) |
2/9. Three cases of didmoad or Wolfram's syndrome: urological aspects.We report on 3 patients with the rare syndrome of diabetes insipidus, diabetes mellitus, optic atrophy, neurosensory deafness, atony of the urinary tract and other abnormalities (DIDMOAD or Wolfram's syndrome). All 3 patients had diabetes mellitus, optic atrophy, deafness and dilatation of the urinary tract. In 2 patients there was diabetes insipidus. The possibility of anatomical outlet obstruction or a neurogenic bladder was eliminated radiologically and urodynamically, and dilatation of the urinary tract was considered to be either a consequence of high diuresis associated with diabetes insipidus or a degenerative process affecting the central and peripheral nervous system, which can explain all of the manifestations of the syndrome except diabetes mellitus. A significant improvement in bilateral urinary tract distention was achieved by bladder drainage in the first 2 cases, while desmopressin therapy dramatically decreased the daily urinary output.- - - - - - - - - - ranking = 0.60440420782384keywords = diabetes insipidus, insipidus, diabetes (Clic here for more details about this article) |
3/9. Nonobstructive urinary tract dilatation in nephrogenic diabetes insipidus.The follow-up study has been performed in 4 male patients with nephrogenic diabetes insipidus lasting for 4 to 15 years. hydronephrosis or hydroureter appeared to be caused by polyuria with or without urinary tract obstruction. The efficacy of drainage operation is emphasized when polyuria surpasses the transporting ability of urine in the urinary tract.- - - - - - - - - - ranking = 0.99816491340673keywords = diabetes insipidus, insipidus, diabetes (Clic here for more details about this article) |
4/9. Urological aspects of Wolfram's syndrome.Two new cases of Wolfram's syndrome associated with progressive urinary tract dilatation are reported. The possibility of anatomic outlet obstruction or neurogenic bladder was eliminated radiologically and urodynamically. dilatation of the urinary tract was considered to be a consequence of high diuresis associated with diabetes insipidus. A very important improvement in bilateral urinary tract distension was achieved with bladder drainage while dDAVP therapy dramatically decreased the daily urinary output. A review of diabetes insipidus and its urological implications is presented.- - - - - - - - - - ranking = 0.39926596536269keywords = diabetes insipidus, insipidus, diabetes (Clic here for more details about this article) |
5/9. Renal papillary necrosis: an update.The clinical and diagnostic features of renal papillary necrosis (RPN) of 27 patients were studied. diabetes mellitus was the most frequent (56%) condition associated with RPN. Analgesic abuse, sickle hemoglobinopathy and urinary tract obstruction were present in 4 patients each; in 6 of these 12 patients these conditions were present as a coexistent disease with diabetes mellitus. There was evidence of an acute or chronic infection of the urinary tract in 18 patients, as a coexistent condition with another underlying disease that itself can cause RPN in 14 patients and as the only cause of RPN in another 4. Thus, the presence of more than one diagnostic condition which might be implicated in the causation of RPN was present in 15 patients or 55% of the cases in this series. When infection was excluded, six patients or 22% of the cases had two coexisting diseases, each of which has been implicated as a cause of RPN. This observation underlines the multifactorial nature of this entity and might explain why RPN is not encountered more frequently in each of the various primary diseases with which it has been associated. The average age of the patients at the time of diagnosis was 53 years for women and 56 years for men. Only six of the patients were younger than 40 years, and three of these had sickle hemoglobinopathy. The diagnosis of RPN was based on x-ray findings in eight patients, on the histologic examination of papillary tissue in urine in one, and on autopsy findings in the rest. Papillary necrosis was bilateral in three-fourths of the cases. The clinical picture varied. Most of the patients (67%) presented with chills and fever. flank pain and dysuria were present in 11 patients (41%). As a rule oliguria was rare and progressive uremia was uncommon. In cases diagnosed at post-mortem, the patients had succumbed to infection or to a primary severe extrarenal disorder with the possibility of RPN having been entertained clinically in only half these cases prior to autopsy.- - - - - - - - - - ranking = 0.0018350865932677keywords = diabetes (Clic here for more details about this article) |
6/9. Complex syndrome in a young girl: Wolfram's syndrome?The combination of juvenile diabetes mellitus, optic atrophy, perceptive hearing loss, diabetes insipidus and atonia of the urinary tract and bladder seems to constitute a distinct syndrome. In certain cases delayed puberty is also mentioned but this has not been considered as part of the syndrome.- - - - - - - - - - ranking = 0.20146806927461keywords = diabetes insipidus, insipidus, diabetes (Clic here for more details about this article) |
7/9. diabetes insipidus and nonobstructive dilation of urinary tract.Two cases of diabetes insipidus (hypothalamic and nephrogenic) with massive nonobstructive trabeculation and dilation of the bladder and hydroureteronephrosis are reported. The cases are evaluated thoroughly--radiologically and urodynamically. Treatment options are discussed, including the use of an important new drug, dDAVP. The general subject of diabetes insipidus and its urologic implications is reviewed.- - - - - - - - - - ranking = 0.5561102949631keywords = diabetes insipidus, insipidus, diabetes (Clic here for more details about this article) |
8/9. Various clinical aspects of DIDMOAD (Wolfram) syndrome.The association of juvenile diabetes mellitus (DM), diabetes insipidus (DI), optic atrophy (OA) and sensorineural deafness (D) is known as DIDMOAD or Wolfram syndrome. Aside from these four cardinal features, a wide variety of abnormalities of the nervous system, urinary tract and endocrine glands have been described in this syndrome. In this report, the clinical features of six patients with DIDMOAD syndrome are presented. All six patients had DM. Five of the six patients had DI, five OA and five displayed abnormal audiogram findings. In addition, two had goiter, two delayed puberty, one seizure and one mental retardation with depression attacks. urinary tract dilatation was recorded in five patients. Four patients developed typical complications of DM. One of them had overt nephropathy and arthropathy despite the short duration of DM. In addition, this patient had diabetic retinopathy, which is considered to be rare in this syndrome.- - - - - - - - - - ranking = 0.20146806927461keywords = diabetes insipidus, insipidus, diabetes (Clic here for more details about this article) |
9/9. Wolfram's (DIDMOAD) syndrome and its urological manifestation.We report 2 patients with DIDMOAD syndrome (diabetes insipidus, diabetes mellitus, optic atrophy and neural deafness), with emphasis on the urological aspects and their management. Both patients underwent thorough radiological endoscopic and urodynamic evaluation, in addition to detailed evaluation of other systems involved. Each had the characteristic hyper-reflexive neurogenic bladder with sphincteric dyssynergia, which resulted in severe urinary tract dilation. One patient was diagnosed at this institution and managed conservatively with clean intermittent catheterisation and anticholinergic medication; the second patient was referred to us after several attempts at surgical correction. The presentation, details of the urological evaluation with special emphasis on the urodynamic findings, and the outcome of different means of management are discussed.- - - - - - - - - - ranking = 0.20146806927461keywords = diabetes insipidus, insipidus, diabetes (Clic here for more details about this article) |