Urodynamic Findings in Patients with Diabetes Mellitus and Lower Urinary Tract Symptoms

Objective: To characterize urodynamic (UDS) findings in North American patients with diabetes mellitus (DM) and lower urinary tract symptoms (LUTS) from a contemporary cohort. Methods: A multi-center UDS database (1997-2010) of 3663 records was analyzed for patients with DM. Statistical analysis used Fisher's exact and Mann-Whitney U tests. Results: 257 patients were identified: 173 men and 84 women.74 patients had insulin-dependent DM (IDDM) and 183 patients noninsulin-dependent DM (NIDDM). Mean age was 70±12 years. The most common diagnosis in all patients was detrusor overactivity (71%). In women, common presenting complaints were frequency (n= 47, 56%), urgency (n=45, 54%), and stress incontinence (SUI) (n=37, 44%). Presenting symptoms in men were frequency (n= 99, 57%), nocturia in (n=83, 48%), and urgency (n=78, 45%). 9(11%) women and 40(23%) men presented in retention. Detrusor underactivity (DU) was present in 26% of patients, including 22% of men and 31% of women (p=0.142). A high proportion of females had both SUI and DU(17%) who 10.4% of men had BOO with DU. Bladder capacity was significantly higher in patients with IDDM (445 vs. 394 mL, p=0.035). Conclusion: In this contemporary series of patients with DM and LUTS from the United States, the most common diagnosis was Do.26% of patients were found to have coexisting DU. Adding DO to the definition of diabetic cystopathy should be considered and these findings suggest it is important to consider UDS in patients with DM and persistent voiding complaints, particularly prior to surgery.