MP76-19 A MODERN COMPARISON OF URODYNAMIC FINDINGS IN NONDIABETIC VERSUS DIABETIC FEMALES

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-neurogenic Voiding Dysfunction1 Apr 2014MP76-19 A MODERN COMPARISON OF URODYNAMIC FINDINGS IN NONDIABETIC VERSUS DIABETIC FEMALES Rena D. Malik, Joshua A. Cohn, Charles Chang, Leah Anderson, Brianne Randall, Gregory T. Bales, and Doreen E. Chung Rena D. MalikRena D. Malik More articles by this author , Joshua A. CohnJoshua A. Cohn More articles by this author , Charles ChangCharles Chang More articles by this author , Leah AndersonLeah Anderson More articles by this author , Brianne RandallBrianne Randall More articles by this author , Gregory T. BalesGregory T. Bales More articles by this author , and Doreen E. ChungDoreen E. Chung More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2412AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Classic diabetic cystopathy has been described as decreased sensation, increased capacity, impaired contractility, and elevated post void residual (PVR). Data is conflicting and few contemporary studies exist regarding urodynamics (UDS) findings in patients with diabetes mellitus (DM). To date no comparative studies exist. Our aim was to compare UDS findings in females with and without DM from a contemporary database. METHODS A retrospectively collected UDS database was searched for females and reviewed. Studies were performed according to International Continence Society Standards. For significance, chi square and Students t tests were performed. RESULTS 344 patients underwent UDS between 2010 and 2013. Of those 93 (27%) had DM. Indications for UDS and symptoms at presentation were similar in both groups, except diabetics more frequently presented with voiding symptoms (15% vs. 8%, p=0.05) and less frequently with nocturia (10% vs. 20%, p=0.03). UDS findings are summarized in table 1. Females with DM had significant delay to first urge sensation (278mL vs. 220mL, p =0.01), larger bladder capacity (mean 479 mL vs. 402mL, p = 0.01), and decreased maximum detrusor pressures (43 cmH2O vs. 57 cmH2O, p= 0.001). A larger proportion of females with DM had detrusor underactivity (29% vs. 17%, p=0.04), abdominal straining during voiding (55% vs. 41%, p=0.03) and a trend towards increase in post void residual (PVR) (53cc vs. 24cc, p=0.09). There was no difference in presence of detrusor overactivity, or stress incontinence between groups. CONCLUSIONS In this contemporary series, women with DM, demonstrated similar presenting complaints to women without DM but had delayed sensation, higher capacity, lower detrusor pressures and increased PVR consistent with classic diabetic cystopathy. These findings suggest that DM does affect bladder function but not symptoms and reinforces the importance of UDS in the workup of DM females, particularly prior to initiation of treatment. Further studies are needed to explore treatment implications of this phenomenon. Table 1. Urodynamic Findings in Females NonDiabetics (n= 251) Diabetics (n= 93) p Value Mean First Sensation ±SD (mL) 136 ± 128 169 ± 167 0.17 Mean First Urge ± SD (mL) 220 ± 158 278 ± 227 0.01 Mean Capacity ± SD (mL) 402 ± 227 479 ± 302 0.01 Mean Qmax ± SD (mL/s) 16 ± 12 19 ± 15 0.10 Mean Pdet at Qmax ±SD (cmH2O) 37 ± 26 27 ± 18 0.002 Mean Max Pdet ±SD (cmH2O) 57 ± 36 43 ± 30 0.001 Detrusor Overactivity (%) 72 (30) 26 (29) 1.0 Stress Incontinence (%) 121 (51) 48 (57) 0.45 Bladder Strength (%) Weak 37 (17) 20 (29) 0.04 Strong 181 (83) 48 (71) Mean PVR ±SD (mL) 34 ± 85 53 ± 109 0.09 Abdominal Straining (%) 96 (41) 47 (55) 0.03 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e889-e890 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Rena D. Malik More articles by this author Joshua A. Cohn More articles by this author Charles Chang More articles by this author Leah Anderson More articles by this author Brianne Randall More articles by this author Gregory T. Bales More articles by this author Doreen E. Chung More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...