The Abnormalities Of Uroflowmetry Of Specific Bladder Capacity In Early Diabetic Cystopathy

ObjectiveStudying the abnormalities of uroflowmetry of specific bladder capacity in early diabetic cystopathy without any lower urinary tract symptoms,in order to find out the abnormalities of uroflowmetry and the diagnostic value of uroflowmetry of specific bladder capacity in the detection of early diabetic cystopathy(DCP).Methods1、One hundred and ten patients with type 2 diabetes mellitus(T2DM)and 50 normal control subjects as the control group were selected.2、All of them were asked for empty stomach.Took peripheral blood samples to study fasting plasma glucose and glycated hemoglobin.“Emptying” their bladder before detecting.Then drank water as what they did everyday and waited.3、Scanned the bladder capacity when they had the first desire to void,and it was the volume leading to first desire to void.Detected immediately if the volume was up to about 300mL(Gave up those whose the volume leading to first desire to void were more than 400mL).Kept waiting and scanning the bladder capacity if the volume was too little until it was up to about 300 ml.Then completed the uroflowmetry.Writed down maximal flow rate(MFR)and average flow rate(AFR)of bladder capacity about 300 ml,and post voiding residual urine volume(PVR)after "emptying" were measured by uroflowmetry.4、The patients with type 2 diabetes mellitus were divided into DCP group and non-DCP group,DM course≥10 years group and DM course<10 years group,newly diagnosed diabetic(DM course<1 year)group and non-newly diagnosed diabetic(DM course≥1 year)group,HbA1 c ≥7% group and HbA1c<7%.Study the abnormalities of uroflowmetry in all groups.Results1、Among the 110 patients with DM,75 cases had post voiding residual urine,66 cases had post voiding residual urine volume more than 10mL(DCP group),so the incidence of DCP was 60.00%(66/110).In control group,9 cases had post voiding residual urine,6 cases had post voiding residual urine volume more than 10 mL,theratio was 12%.The MFR and AFR in DM group were significantly lower than those in control group:(15.09±5.90)ml/s 、(9.70±4.51)ml/s vs.(23.20±5.78)ml/s 、(15.45±4.78)ml/s,and 15.50(0~35)ml vs.0.00(0.00~0.00)ml,and there were statistical differences(P<0.05).2、The AFR and MFR in DCP group and non-DCP group were significantly lower than those in control group:(14.06±5.77)ml/s and(17.46±5.88)ml/s vs.(23.20±5.78)ml/s、(9.09±4.10)ml/s and(10.87±5.17)ml/s vs.(15.45±4.78)ml/s,and there were statistical differences(P<0.05).The MFR in DCP group were significantly lower than those in non-DCP group;but there were no statistical differences of MFR between DCP group and non-DCP group.3、After exclusion of the cause of age,the MFR and AFR in DM course≥10years group(27 cases)and DM course<10 years group(83 cases)were significantly lower than those in control group:(13.34±5.48)ml/s and(16.10±6.06)ml/s vs.(23.20±5.78)ml/s,(8.62±3.28)ml/s and(10.19±4.93)ml/s vs.(15.45±4.78)ml/s,and the post voiding residual urine volume was significantly higher than that in control group: 18(0~75)ml and 15(0~31)ml vs.0(0-0)ml.The MFR in DM course≥10 years group was significantly lower than that in DM course<10 years group,and the post voiding residual urine volume was significantly higher than that in DM course<10 years group,and there were statistical differences(P<0.05).4、The MFR and AFR in HbA1c≥7% group(921cases)and HbA1c<7% group(19 cases)were significantly lower than those in control group:(15.43±5.97)ml/s and(15.36±6.44)ml/s vs.(23.20±5.78)ml/s,(9.82±4.67)and(9.72±4.51)ml/s vs.(15.45±4.78)ml/s,and the post voiding residual urine volume was significantly higher than that in control group: 17(0~35)ml and 10(0~35)ml vs.0(0~0)ml.There were statistical differences(P<0.05).There were no statistical differences between HbA1c≥7% group and HbA1c<7% group(P>0.05).5 、 After exclusion of the cause of age,the MFR in non-newly diagnosed diabetic(DM course≥1 year)group(80 cases)were significantly lower than those in the other two groups:(14.01±5.80)ml/s vs.(19.18±4.94)ml/s and(23.20±5.78)ml/s.And the post voiding residual urine volume was significantly higher than those in the other two groups: 19(2.25~35.75)ml vs.3(0~21.5)ml and 0(0~0)ml.The AFRin non-newly diagnosed diabetic group was significantly lower than that in control group:(9.27±4.30)ml/s vs.(15.45±4.78)ml/s;but there were no statistical differences of MFR with newly diagnosed diabetic group:(9.27±4.30)ml/s vs.(11.22±5.18)ml/s.The MFR and AFR in newly diagnosed diabetic were significantly lower than that in control group:(19.18±4.94)ml/s vs.(23.20±5.78)ml/s and(11.22±5.18)ml/s vs.(15.45±4.78)ml/s.There were no statistical differences in residual urine volume :3(0~21.5)ml vs.0(0-0)ml(P>0.05).There were no statistical differences in volume leading to first desire to void(P>0.05).Conclusions1、 MFR decrease and post voiding residual urine volume detected with the technology of uroflowmetry in specific bladder capacity may be used in detection of early DCP,and the decreasion of MFR is earlier than bladder residual urine.2、 Uroflowmetry may be used to the screening of early DCP.