Dear Editor,

We read with interest the article by Ströher et al. entitled "Metabolic syndrome in women with and without stress urinary incontinence" published recently in your journal [1]. It presents the data from a valuable study, trying to compare the frequency of metabolic syndrome in patients with and without stress urinary incontinence. The main conclusion of the study was that metabolic syndrome frequency was higher in patients with stress urinary incontinence, suggesting a possible association between these two conditions.

The article provides a comprehensive list of studies related to the topic and engages in a profound discussion about the collected and analyzed data, leading to a very interesting debate.

Nevertheless, we would like to ask the authors one question that may contribute to further, more detailed discussion of the issue.

The authors correctly mentioned type 2 diabetes mellitus as a risk factor for stress urinary incontinence [2]. The definitions of metabolic syndrome which were used in the study [3, 4] are both based partly on the presence of elevated fasting plasma glucose or antidiabetic treatment, either of which may indicate diabetes mellitus. Unfortunately, the authors did not state if there were any diabetic patients among the study group. If there were, this could partially put the study results in doubt, suggesting that it could be the investigation of the relation of stress urinary incontinence not only to metabolic syndrome but at the same time also to diabetes mellitus (we could even speculate that all the patients diagnosed with metabolic syndrome could suffer from type 2 diabetes).

Therefore, we would like to respectfully ask if the authors could provide information about the prevalence of diabetes among the study group, and we suggest taking into account this comment when deciding on the protocol of this interesting and important study if its continuation is planned.