A study of bladder dysfunction in women with type 2 diabetes mellitus

Abstract

Introduction:Diabetes mellitus has been associated with an earlier onset and increased severity of urologic diseases that often result in debilitating urologic complications. Diabetic bladder dysfunction refers to a group of bladder symptoms occurring in patients with diabetes mellitus ranging from bladder over activity to impaired bladder contractility.Aim:Bladder dysfunction is an under evaluated issue in women with diabetes. Aim of our study was to investigate prevalence of bladder dysfunction and its relation with other chronic complications of diabetes in women with type 2 diabetes.Materials and Methods:In a hospital-based cross sectional study, a cohort of women with type 2 diabetes mellitus who had lower urinary tract symptoms (LUTS) were enrolled. We used the American Urological Association Symptom Index (AUA-SI) to assess the severity of LUTS and the Indevus Urgency Severity Scale (IUSS) to assess presence of overactive bladder (OAB). Age-BMI- matched controls that did not have diabetes but had lower urinary tract symptoms were also studied and compared with women with type 2 diabetes. Urodynamic evaluation was done in willing patients.Results:LUTS attributable to bladder dysfunction were reported in 67% of women with type 2 diabetes after exclusion of other causes. Out of them, 36% had moderate to severe LUTS (total AUA-SI score >7). Prevalence of OAB was 53%. Urodynamic evaluation revealed presence of stress urinary incontinence in 48% patients and changes of detrusor over activity and detrusor under activity in 23% and 11% patients, respectively. Among the chronic complications of diabetes, peripheral neuropathy, nephropathy, and presence of metabolic syndrome were significantly associated with moderate to severe LUTS and OAB.Conclusion:Bladder dysfunction is a highly prevalent complication in women with diabetes. Chronic complications of diabetes especially neuropathy, nephropathy, and presence of metabolic syndrome are important predictors of bladder dysfunction.

Functional and morphological alterations of the urinary bladder in type 2 diabetic FVBdb/db mice

“…Similarly, recent clinical studies also showed the mixed picture of DBD in T2DM patients (Lee et al, 2009; Karoil et al, 2014). Therefore, FVB db/db mouse model is a useful model for further understanding the pathophysiology of T2DM-related bladder dysfunction.…”

Diet Modification for Overactive Bladder: an Evidence-Based Review

“…Duration of diabetes has also been shown to be an independent risk factor for OAB. However, the same study noted that glycemic control appeared to have no impact on LUTS or OAB [19].…”

Types of Urinary Incontinence Prevalent among Kuwaiti Women with Type Two Diabetes Mellitus

“…Another classification of UI is according to the symptoms exhibited by the sufferer, which include: stress incontinence, urge incontinence also referred to as over active bladder (OAB), mixed incontinence which is a combination of the previous two types, unspecified urinary incontinence, functional urinary incontinence, total incontinence, nonorganic enuresis, and urinary incontinence associated with cognitive impairment [3] [6] [7] [8] [9]. The three common types of UI affecting women are stress urinary incontinence, urge incontinence/OAB and mixed incontinence.…”

“…The second most common type of UI in women is urge incontinence/OAB as a result of over activity of the detrusor muscles. Common reactions specific to urge incontinence/OAB are frequency, urgency, and nocturia [7]. The third type is the mixed incontinence, which is the presence of both stress incontinence and urge incontinence/OAB in the individual.…”

“…Urinary frequency is one of the reactions of type two DM and it is one of the main common reactions present in urge incontinence/OAB. To clearly differentiate the symptoms of urge incontinence/OAB from urinary symptoms associated with type two DM, it may be necessary to perform urodynamic studies [7]. Diabetic bladder dysfunction has been reported as a spectrum of urge incontinence/OAB and its prevalence was reported to be from 25% to 87% [9].…”