Urodynamics in Early Diagnosis of Diabetic Bladder Dysfunction in Women: A Systematic Review and Meta-Analysis

Abstract

BackgroundUrodynamics can detect subtle voiding changes before cystopathy symptoms manifest. The aim of the present study was to assess urodynamic changes in diabetic women.Material/MethodsA systematic search was performed on 04 November 2021 to identify studies reporting urodynamic parameters in diabetic women. Data were analyzed in a single-arm meta-analysis due to lack of sufficient studies with direct comparisons to healthy women. For data synthesis, a random-effects model with restricted maximum-likelihood estimation was applied. The calculated effect sizes were visualized in forest plots. Statistical heterogeneity was assessed using the I2 measure and the χ2 test. The risk of bias was assessed using the QUIPS tool. PROSPERO ID: CRD42021256275.ResultsOut of 1750 records, 10 studies were used in the analysis (n=2342 diabetic women). Pooled event rates showed that mean voided volume was 288.21 mL [95% confidence interval (CI): 217.35–359.06, I2=98%], mean postvoid residual volume was 93.67 mL [95% CI: 31.35–155.99, I2=100%], mean Qmax was 18.80 mL/sec [95% CI: 15.27–22.33, I2=99%], mean PdetQmax is 30.13 cmH2O [95% CI: 25.53–34.73, I2=90%], mean first sensation of bladder filling was 178.66 mL [95% CI: 150.59–206.72, I2=97%], and mean cystometric capacity was 480.41 mL [95% CI: 409.32–551.50, I2=98%] in diabetic women.ConclusionsPooled results indicate that diabetic women tend to have a smaller voided volume, slower Qmax and PdetQmax, larger postvoid residual, and higher first sensation of bladder filling and cystometric capacity compared to the general female population.