КЛИНИЧЕСКИЕ ОСОБЕННОСТИ И ЛЕЧЕНИЕ УРОГЕНИТАЛЬНОЙ ДИАБЕТИЧЕСКОЙ АВТОНОМНОЙ НЕЙРОПАТИИ

Аннотация

The urogenital form of diabetic autonomic neuropathy (DAN) is a common yet underdiagnosed complication of diabetes, severely affecting quality of life. This review covers clinical manifestations like bladder and erectile dysfunction, diagnostic methods, and treatments, including glycemic control, PDE5 inhibitors, neuromodulation, and emerging therapies. Persistent challenges highlight the need for multidisciplinary approaches and further research into personalized strategies. Keywords: diabetic autonomic neuropathy (DAN), urogenital dysfunction, bladder dysfunction, erectile dysfunction, neurophysiological diagnostics, multidisciplinary treatment. Annotatsiya: Diabetik vegetativ neyropatiyaning (DVN) urogenital shakli diabetning keng tarqalgan, ammo tashxislanmagan asorati bo‘lib, hayot sifatiga jiddiy ta’sir qiladi. Ushbu sharhda siydik pufagi va erektil disfunksiyasi, diagnostika usullari va davolash usullari, jumladan glikemik nazorat, PDE5 ingibitorlari, neyromodulyatsiya va rivojlanayotgan terapiya kabi klinik ko‘rinishlar yoritilgan. Doimiy 59 Universaljurnal.uz Universal International Scientific Journal 2025, 2(1) muammolar ko‘p tarmoqli yondashuvlar va shaxsiylashtirilgan strategiyalarni yanada tadqiq qilish zarurligini ta’kidlaydi. Kalit so‘zlar: diabetik vegetativ neyropatiya (DAN), urogenital disfunksiya, siydik pufagi disfunksiyasi, erektil disfunksiya, neyrofiziologik diagnostika, ko‘p tarmoqli davolash. Аннотация: Урогенитальная форма диабетической вегетопатии (ДВН) является распространенным, но недостаточно диагностируемым осложнением диабета, серьезно влияющим на качество жизни. Этот обзор охватывает такие клинические проявления, как дисфункция мочевого пузыря и эрекции, методы диагностики и лечения, включая контроль гликемии, ингибиторы PDE5, нейромодуляцию и новую терапию. Постоянные вызовы подчеркивают необходимость многодисциплинарных подходов и дальнейших исследований персонализированных стратегий. Ключевые слова: диабетическая вегетативная нейропатия (ДВН), урогенитальная дисфункция, дисфункция мочевого пузыря, эректильная дисфункция, нейрофизиологическая диагностика, многопрофильное лечение. Language: English Citation: Pirmatov , S. (2025). CLINICAL FEATURES AND TREATMENT OF UROGENITAL DIABETIC AUTONOMIC NEUROPATHY. Universal International Scientific Journal, 2(1), 59–67. https://doi.org/10.69891/3060-4540.2025.39.71.001 Doi: https://doi.org/10.5281/zenodo.14711437 Google scholar: https://scholar.google.com/scholar?hl=ru&as_sdt=0%2C5&q=CLINICAL+FEATURES+AND+TREATMENT+OF+UROGENITAL+DIABETIC+AUTONOMIC+NEUROPATHY&btnG= Crosreff doi: https://doi.org/10.69891/3060-4540.2025.39.71.001 INTRODUCTION. of women suffering from urinary Diabetic autonomic polyneuropathy incontinence. These dysfunctions are (DAN) significantly impacts the urogenital linked to abnormalities in the detrusor system, manifesting as diabetic bladder muscle, urothelium, and urethra, and are dysfunction, sexual dysfunction, and influenced by neurogenic, vasculogenic, recurrent urinary tract infections, which are hormonal, metabolic, drug-induced, and more prevalent than other diabetic psychological factors[2]. The UroEDIC complications like neuropathy or study, part of the DCCT/EDIC research, nephropathy[1]. The prevalence of these highlighted significant associations conditions is notably high, with over 50% between cardiovascular autonomic of individuals with diabetes experiencing neuropathy and urologic complications, lower urinary tract symptoms (LUTS) and underscoring the need for comprehensive erectile dysfunction (ED), and up to 39% management strategies[1,3]. 60 Universaljurnal.uz Universal International Scientific Journal 2025, 2(1) Understanding the prevalence and quality- those responsible for erectile function in of-life implications of these conditions is men and sexual function in women, as well crucial, as they severely affect patients' as lower urinary tract symptoms[1]. The well-being and are often prevalence of urogenital diabetic underdiagnosed[4]. Effective clinical neuropathy is notably high, with studies management requires a multidisciplinary such as the UroEDIC study highlighting approach, incorporating lifestyle significant associations between interventions, pharmacological treatments, cardiovascular autonomic neuropathy and and psychological counseling. Recent urologic complications in individuals with advancements in antihyperglycemic drugs type 1 diabetes[1,3]. Risk factors for also show promise in improving sexual developing these complications include function through weight control[2]. poor glycemic control, longer duration of Despite these developments, there remains diabetes, and associated cardiovascular a critical need for further research to risk factors. Demographically, the enhance diagnostic and treatment prevalence and incidence of autonomic protocols, as well as to address the social neuropathy, including urogenital determinants of health that influence the manifestations, vary wi