Clinical significance of diabetes mellitus on detrusor functionality on stress urinary incontinent women without bladder outlet obstruction

INTRODUCTION AND HYPOTHESIS - Our aim was to evaluate the effect of diabetes mellitus (DM) on detrusor contractility (DC) in women without bladder outlet obstruction (BOO) by using urodynamic study (UDS).

METHODS - We reviewed the clinical records of 863 consecutive women without BOO, each of whom was diagnosed with stress urinary incontinence (SUI) by UDS.

Uroflowmetry measurements included maximal flow rate (Qmax), time to Qmax, voided volume, and postvoid residual urine volume (PVR). Data from filling cystometry included the first strong desire to void and the Valsalva leak-point pressure (VLPP). For voiding cystometry data, detrusor pressure at Qmax (Pdet@Qmax) and bladder contractility index (BCI) were analyzed. In the DM group, the level of glycosylated hemoglobin (HbA1c) and DM duration were measured.

RESULTS - After the application of exclusion criteria, complete UDS data of 708 patients were available. The cohort was divided into two groups according to DM status. The DM group comprised 92 (12.9 %) patients, the non-DM group 616 (87.0 %). Mean maximal flow rate and Pdet@Qmax and bladder contractility index were lower in the DM group, in whom mean DM duration was 9.24 ± 7.63 years and mean HbA1c level 7.27 ± 1.43 %. DM duration was significantly correlated with Qmax (-0.309, p = 0.003), Pdet@Qmax (-0.369, p < 0.001), and BCI (-0.409, p < 0.001). Moreover, the HbA1c level was significantly correlated with Qmax (-0.256, p = 0.016), Pdet@Qmax (-0.231, p = 0.026), and BCI (-0.308, p = 0.002).

CONCLUSIONS - Our UDS data revealed that DM is associated with impaired DC in women without BOO. Moreover, longer DM duration and poor glycemic control were associated with impaired DC.

International urogynecology journal. 2016 Mar 18 [Epub ahead of print]

Yu Seob Shin, Ji Won On, Myung Ki Kim

Department of Urology, Chonbuk National University Medical School, and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, 561-712, South Korea., Department of Urology, Chonbuk National University Medical School, and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, 561-712, South Korea., Department of Urology, Chonbuk National University Medical School, and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, 561-712, South Korea. 

Pelvic Health Weekly Newsletter