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Urodynamic and questionnaire findings in urinary incontinent women with and without diabetes. Data from a health study

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Abstract

Introduction and hypothesis

Our aim was to compare urodynamic findings in urinary incontinent (UI) women with and without diabetes.

Methods

In the extensive Lolland-Falster Health Study, women with lower urinary tract symptoms were offered urodynamic testing. After excluding 6 women with incomplete urodynamic testing and 88 women without UI, our analysis ended up including 417 women (31 with and 386 without diabetes). Student’s t-test and chi-squared test were used to compare differences of urodynamic findings. Urodynamic testing consisted of a 2-day bladder diary, post-void residual urine volume, filling cystometry, pressure-flow study, cough stress test, and uroflowmetry. Three experienced physicians in urogynecology evaluated all urodynamic findings leading to an overall conclusion of the test results.

Results

Self-reported data showed that compared to incontinent women without diabetes, incontinent women with diabetes had more frequent leakage, a larger amount of leakage, and a higher ICIQ score. A positive ICS Uniform cough stress test was more prevalent in women with diabetes. There were no significant differences in other urodynamic findings or overall conclusion between the two groups. Controlling for age and BMI did not affect our findings.

Conclusions

Women with diabetes complained more about UI, had a higher ICIQ score, and had a positive ICS Uniform cough stress test more often than women without diabetes. Based on these findings, we recommend to include the history of urinary incontinence in the care of women with diabetes. This sample consists of women from a comprehensive health study with different severity of UI. Therefore, it can serve as a reference cohort for future studies.

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Abbreviations

BMI:

Body mass index

DOA:

Detrusor overactivity

HbA1c:

Glycated hemoglobin

ICIQ OAB:

International Consultation of Incontinence Questionnaire-Overactive Bladder

ICIQ-UI SF:

International Consultation of Incontinence Questionnaire-Urinary Incontinence Short Form

ICS:

International Continent Society

LOFUS:

Lolland-Falster Health Study

LUTS:

Lower urinary tract symptoms

MUI:

Mixed urinary incontinence

PdetQmax:

Voiding detrusor pressure at maximum flow rate

PVR:

Post-void residual urine volume

SLGT2 inhibitor:

Sodium-glucose cotransporter-2 inhibitor

SUI:

stress urinary incontinence

USI:

Urodynamic stress incontinence

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Acknowledgements

The authors thank the women participating and contributing with valuable data for this study. Another acknowledgment and thanks go to the three specialist nurses for contributing with the assessment of the many urodynamic tests: Jette Fauerholm, Lene Bønnelykke, and Jytte Pedersen, and to the Department of Gynecology and Obstetrics, Nykøbing Falster Hospital, for lending us urodynamic equipment for our test. The Lolland-Falster Health Study (LOFUS), Nykøbing Falster Hospital, Denmark, is a collaboration between Lolland and Guldborgsund Municipalities, Region Zealand, and Nykøbing Falster Hospital. The authors are grateful to LOFUS for collaborating and making the LOFUS research data available. However, LOFUS bears no responsibility for analyses or interpretations conducted within this study.

Funding

This study was funded by Nykøbing Falster Hospital; Department of Gynecology and Obstetrics, Nykøbing Falster Hospital; Region Zealand Health Research Fund; Department of Gynecology and Obstetrics, Zealand University Hospital, Roskilde; Production, Research and Innovation, Region Zealand; "Cutting the Edge” prize from Astellas to co-supervisor Lea Laird Andersen; Edith and Henrik Henriksens Memorial Fund; King Christian X's memorial Fund; Grosserer L.F. Foghts Fund; Aase and Ejnar Danielsen Fund; AP Møller Fund.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Nykøbing Falster Hospital, Fjordvej 15, 4800, Nykøbing Falster, Denmark

    Ea Papsø Løwenstein

  2. Department of Regional Health Research, University of Southern Denmark, Odense, Denmark

    Ea Papsø Løwenstein & Helga Gimbel

  3. Department of Obstetrics and Gynecology, Holbæk Hospital, Holbæk, Denmark

    Lea Laird Andersen

  4. Department of Obstetrics and Gynecology, Zealand University Hospital, Roskilde, Denmark

    Lars Alling Møller & Helga Gimbel

  5. Department of Obstetrics and Gynecology, Bornholm Hospital, Rønne, Denmark

    Jennie Laigaard

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  1. Ea Papsø Løwenstein
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  2. Lea Laird Andersen
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  3. Lars Alling Møller
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  4. Jennie Laigaard
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  5. Helga Gimbel
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Contributions

E Løwenstein: Protocol/project development, Data collecting and management, Data analyses, Manuscript writing and editing.

LL Andersen: Project development, Manuscript editing.

J Laigaard: Project development, Data management, Manuscript editing.

LA Møller: Project development, Data management, Manuscript editing.

H Gimbel: Protocol/project development, Data management, Manuscript writing and editing.

Corresponding author

Correspondence to Ea Papsø Løwenstein.

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Løwenstein, E.P., Andersen, L.L., Møller, L.A. et al. Urodynamic and questionnaire findings in urinary incontinent women with and without diabetes. Data from a health study. Int Urogynecol J 32, 2847–2856 (2021). https://doi.org/10.1007/s00192-021-04950-4

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