Urodynamic Evaluation Diabetic Women Above 60 Years Old With Abnormal Voiding

ObjectiveTo investigate the urodynamic changes of the aged diabetic women above 60 years old with abnormal voiding and its clinical significance.MaterialsA total of 57 diabetic patients aged 60-88 (69.3±7.0y) with abnormal voiding were included. In this study filling cystometry,pressure-flow and static dynamic urethral pressure study were performed according to the recommendations of International Continence Society (ICS). Forty cases aged 60～86 years old who were not diabetic patients with abnormal voiding and 20 cases over 60 years old (68.3±4.2y) with no abnormal voiding were included as normal control. The proportion of every panel of both diabetic and nondiabetic patients was equivalent, and the differences were not statically significant.MethodsTo analyze the urodynamic parameters of the 57 diabetic mellitus patients retrospectively and compare them with different groups. The urodynamic parameters include Initial urinate bladder capacity, maximum flow rate (RMF), maximum cystometric capacity (VMCC), detrusor pressure at maximum flow rate (PQmax), bladder compliance (BC), post void residual (VPR), maximum urethral pressure (PMU),maximum urethral closure pressure (PMUC). ResultsThe diabetic group was divided into 3 subgroups according to the urodynamic study. The detrusor underactive (DU) was found in 38.6% (22/57), detrusor overactivity (DO) was found in 19.3%(11/57), bladder outlet obstruction (BOO) was found in 24.6%(14/57) and the normal urodynamic pattern was found in 17.5% (10/57) in diabetic patients respectively. Compared to normal control group, the diabetic patients with DU showed that PQmax (6.2±9.0)cm H2O vs. (30.4±7.8) cmH20, BC (54.7±30.5) ml·kPa-1 vs. (81.9±30.7)ml·kPa-1, VMCC (592.1±165.2)ml vs. (457.5±148.2)ml, VPR (254.3±264.1)ml vs. (13.7±11.3)ml, the differences were statically significant(P<0.05). Compared to normal control group, the diabetic patient with DO showed that BC(41.9±25.4) ml·kPa-1 vs. (81.9±30.7)ml·kPa-1, RMF (12.0±8.0) ml·s-1 vs. (18.5±6.1) ml·s-1, VPR (89.1±98.4)ml vs. (13.7±11.3) ml, the differences were statically significant(P<0.05). Compared to normal control group, the diabetic patients with BOO showed that PQmax was (56.0±21.3) cm H2O vs. (30.4±7.8) cm H2O, BC (35.9±27.3) ml·kPa-1 vs. (81.9±30.7) ml·kPa-1, RMF (6.4±3.3) ml·s-1 vs. (18.5±6.1) ml·s-1, VPR(212.5±233.1)mlvs. (13.7±11.3) ml, PMU(108.0±29.2) cm H2O vs. (80.0±19.0)cm H2O, PMUC (89.2±20.8) cmH2O vs. (65.8±17.1)cmH2O, the differences were statically significant(P<0.05). Compared to nondiabetic group, the initial urinate bladder capacity of diabetic group (233.3±89.5)ml vs.(180.7±84.2) ml is more, the diabetic patients with DU showed that VMCC (592.1±165.2)ml vs. (468.8±101.3)ml, the differences were statically significant (P<0.05).ConclusionThe incidence of bladder dysfunction urodynamically in aged diabetic women above 60 years old was high. Over one third showed DU. In addition, DBD showed BOO and DO too. Compared to nondiabetic group, That the initial urinate bladder capacity and VMCC of diabete group were more implied that the bladder sensitivity cut down. Urodynamic study is a valuable diagnose tool and could provide important evidence for guiding the treatment of aged diabetic women with bladder dysfunction.