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Clinical and urodynamic evaluation of women referred with diabetes mellitus

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Abstract

Introduction and hypothesis

We investigated the impact of diabetes mellitus (DM) on female lower urinary tract dysfunction.

Methods

We prospectively collected data of 1,640 consecutive diabetic women from the inpatient departments and outpatient clinics of urology, endocrinology, geriatrics, and nephrology in primary, secondary, and tertiary referral hospitals, rural healthcare stations, and nursing homes in Dujiangyan, China. Clinical histories were taken on an individualized basis depending on patient presentation. Urodynamics were performed in the enrolled female diabetic patients after excluding other causes of lower urinary tract dysfunction. Data on lower urinary tract symptoms and urodynamic parameters were analyzed.

Results

Ninety-three percent of diabetic women complained of lower urinary tract symptoms, and 88 % had positive urodynamic findings. Sixty-three percent presented with storage symptoms, 918 cases of which had detrusor overactivity, 787 impaired detrusor contractility, and 131 detrusor areflexia. Among the 918 patients with impaired detrusor contractility or detrusor areflexia, the mean first sensation of filling was 238.1 ml, with a mean maximum cystometric capacity of 624 ml, mean maximum flow rate of 9.6 ml/s, mean detrusor pressure at maximum flow rate of 32.4 cmH2O, and mean postvoid residual of 323 ml. Thirty-eight of 131 patients with detrusor areflexia had impaired renal function on blood chemistry test, and massive bilateral ureterohydronephrosis and “Christmas-tree-shaped” bladder in videourodynamic studies. On the whole, 95 % diabetic women had diabetic cystopathy.

Conclusions

DM alters voiding patterns significantly, causing various lower urinary tract symptoms in a significant proportion of diabetic women. Diabetic cystopathy is a progressive condition with a spectrum of clinical symptoms and urodynamic findings. The prevalence of diabetic cystopathy is very high in Dujiangyan, China.

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Acknowledgments

I express my sincerest gratitude and appreciation to all those who gave me the opportunity to complete this study. I extend my thanks to the all doctors, faculties, and staff members in all hospitals, rural healthcare stations, nursing homes throughout Dujiangyan City, and the Dujiangyan Health Bureau for their assistance. Finally, special recognition goes to my family, especially my wife, Lei Jing, and my son, Yuan Leilei, whose support, encouragement, and patience helped me while I researched and wrote this paper.

Conflicts of interest

This study was supported by Science and Technology Department of Sichuan Province, P.R. China. We declare that we have no financial and personal relationships with people or companies that can inappropriately influence our work.

Dr. Yuan ZhengYong, Dr. He Changxiao, and Prof. Shen Hong designed the study, developed the protocol, participated in and supervised data collection, performed data analysis, and wrote the paper. Dr. Yan Shibing, Dr. Wu Caiwen, Dr. Huang Yingchuan and colleagues. participated in data collection and manuscript writing.

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Authors and Affiliations

  1. Department of Urology, Dujiangyan Medical Center, No.622, Baolian Rd, Dujiangyan, 611830, China

    He Changxiao, Yuan Zhengyong, Yan Shibing, Huang Yingchuan, He Wei, Wang Hanhui & Li Dong

  2. Department of Urology, Chongqing Medical University, No.1, Yixueyuan Rd., Yuzhong District, 400016, Chongqing, China

    Yuan Zhengyong

  3. Department of Urology, Second Clinic Area of Dujiangyan Medical Center, No.37, Jianshe Rd, Dujiangyan, 611830, China

    Wu Caiwen

  4. Department of Endocrinology, Dujiangyan Medical Center, No.622, Baolian Rd, Dujiangyan, 611830, China

    Huang Peng

  5. Department of Financial Accounting, Dujiangyan Medical Center, No.622, Baolian Rd, Dujiangyan, 611830, China

    Lei Jing

  6. Department of Nursing, Dujiangyan Medical Center, No.622, Baolian Rd, Dujiangyan, 611830, China

    Zhou Rui

  7. Department of Internal Medicine, Dujiangyan Second People’s Hospital, No.89, Fazhan Rd, Dujiangyan, 611830, China

    Liao Jia

  8. Department of Urology, West China Hospital, Sichuan University, No.37 Guoxuexiang Street, Chengdu, 610041, China

    Yan Shibing & Shen Hong

Authors
  1. He Changxiao
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  2. Yuan Zhengyong
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  3. Yan Shibing
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  4. Wu Caiwen
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  5. Huang Yingchuan
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  6. He Wei
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  7. Wang Hanhui
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  8. Li Dong
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  9. Huang Peng
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  10. Lei Jing
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  11. Zhou Rui
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  12. Liao Jia
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  13. Shen Hong
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Corresponding author

Correspondence to Yuan Zhengyong.

Additional information

Dr. Yuan Zhengyong and Dr. He Changxiao contributed equally to this study.

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Changxiao, H., Zhengyong, Y., Shibing, Y. et al. Clinical and urodynamic evaluation of women referred with diabetes mellitus. Int Urogynecol J 25, 979–983 (2014). https://doi.org/10.1007/s00192-014-2354-5

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  • DOI: https://doi.org/10.1007/s00192-014-2354-5

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