Effects of Diabetes on Female Voiding Behavior

Lee, Wei‐Chia; Wu, Huey-Peir; Tai, Tong-Yuan; Liu, Shih‐Ping; Chen, Jun; Yu, Hong-Jeng

doi:10.1097/01.ju.0000136255.83054.0c

Cited by 88 publications

(72 citation statements)

References 15 publications

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“…These findings are different from other reports that noticed increased PVR and decreased functional capacity in diabetic DO individuals (2,15); but similar to those suggesting that conditions affecting nervous system may induce stronger overactive contractions at higher volume (16).…”

Section: Discussioncontrasting

confidence: 57%

Detrusor overactivity in diabetic and non-diabetic patients: is there a difference?

2012

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ARTICLE INFO _________________________________________________________ ___________________Purpose: To compare urodynamic characteristics in patients with idiopathic detrusor overactivity (IDO) with those of an age matched cohort with diabetes mellitus (DM) and detrusor overactivity (DO). Secondly, to determine whether urodynamic features could help distinguish these two groups of patients. Materials and Methods: Urodynamic data was collected on 58 female patients; 29 with IDO and 29 with DM and detrusor overactivity. Eight urodynamic parameters were selected for analysis: amplitude of the first overactive contraction (AOFC), the volume at the first contraction, cystometric capacity, maximal detrusor pressure, maximal flow rate, voiding pressure at maximal flow, voided volume and postvoid residual (PVR) urine volume. Finally, sensitivity analysis for distinguishing urodynamic parameters between studied groups was performed. Results: AOFC, volume at AOFC and maximal detrusor pressure were statistically greater in diabetic patients, compared with the non-diabetic group of women (16.00 cm H 2 O versus 9.00 cm H 2 O, 309.00 mL versus 167.00 mL and 76.48 cm H 2 O versus 55.41 cm H 2 O respectively). A specificity of 72.41% and positive predictive value of 71.43% were achieved for AOFC with cutoff value of 12 cm H 2 O. These parameters were further improved with cutoff value of 258 mL for volume at AOFC and were 75.86% and 73.08% respectively. Conclusions: Certain urodynamic parameters in diabetic female patients with DO are shown to be significantly different than those in women with IDO. Further prospective study should provide additional information about the pathogenesis and progression of DO in diabetic patients as well as the validity of diabetic screening in patients with IDO.

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Section: Discussioncontrasting

confidence: 57%

Detrusor overactivity in diabetic and non-diabetic patients: is there a difference?

2012

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“…Current understanding correlates LUT dysfunction with changes in the detrusor muscle, urothelium, and central nervous system control of the bladder, but comprehensive risk factors for the development of UI remain unclear (1,33). Clinical urodynamic studies suggest that the effects of DMII on voiding in women produces lower maximal flow rates and higher residual volume than agematched controls, but conflicting data exist (17).…”

Section: Discussionmentioning

confidence: 99%

“…Previous animal models have focused on the effects of type 1 diabetes (DMI) on micturition behavior: streptozotocin (STZ) has been used to induce diabetes in both rats and mice (2,8,20,32) while an additional model of spontaneous biobreeding rats has also been utilized (22). These studies have shown the increased bladder weight, capacity, and compliance typical of the clinical presentation of diabetes (17).…”

mentioning

confidence: 99%

Voiding function in obese and type 2 diabetic female rats

Gasbarro

Lin²,

Vurbic³

et al. 2010

American Journal of Physiology-Renal Physiology

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The effects of obesity and type 2 diabetes (DMII) on the lower urinary tract (LUT) were characterized by evaluating voiding function and anatomy in female Zucker diabetic fatty (ZDF) rats. Age-matched female virgin rats were separated into three experimental groups: Zucker lean rats (control; normal diet, n = 22), ZDF rats (obese+nondiabetic; low-fat diet, n = 22), and ZDF rats (obese+diabetic; high-fat diet, n = 20). Rats were placed on their specified diet for 10 wk before urodynamic LUT evaluation. A suprapubic catheter was implanted 2 days before urodynamic studies. Voiding function was evaluated by cystometric and leak point pressure (LPP) testing. The bladder, urethra, and vagina were immediately excised for qualitative histological evaluation. Compared with control rats, obese+nondiabetic and obese+diabetic rats had significantly decreased contraction pressure ( P = 0.003) and increased cystometric filling volume ( P < 0.001). Both obese groups exhibited significantly higher voided volumes ( P = 0.003), less frequent urinary events ( P < 0.001), and increased residual volumes ( P = 0.039). LPP studies showed a nonsignificant decrease in LPP ( P = 0.075) and baseline pressure ( P = 0.168) in both obese groups compared with control. Histology of the external urethral sphincter in obese rats showed increased fibrosis, leading to disruption of the skeletal muscle structure compared with control. Additionally, the bladder wall of the obese+nondiabetic and obese+diabetic rats demonstrated edema and vasculopathy. Voiding dysfunction was evident in both obese groups but with no significant differences due to DMII, suggesting that voiding dysfunction in DMII may be attributable at least in part to chronic obesity.

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“…Indeed, it was previously demonstrated that systemic diseases, such as hypertension, has been shown to be another factor related with nocturia both in normal [7][8][9][10] and in patients with T2DM. [12][13][14] However, in all these studies, peripheral BP measurements were evaluated. However, it is now apparent that apart from peripheral BP, central hemodynamic parameters are important for cardiovascular prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed not in all, 11 but some studies have shown that T2DM is associated with nocturia. [12][13][14] The presence of hypertension is common in patients with T2DM. 15 It is also now clear that, apart from peripheral BP, central hemodynamic parameters are important for cardiovascular prognosis.…”

Section: Introductionmentioning

confidence: 99%

Central hemodynamics, vascular stiffness, and nocturia in patients with type 2 diabetes

Afsar

Elsürer

2015

Renal Failure

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Recently, studies have shown that the presence of nocturia may not be a benign condition and related with systemic illness and mortality. Elevated blood pressure (BP) was another factor related with nocturia. Type 2 diabetes mellitus (T2DM) is also associated with nocturia. It is now clear that, apart from peripheral BP, central hemodynamic parameters are important for cardiovascular prognosis. However, no previous study in the literature examined the relationship between nocturia and central hemodynamic parameters in patients with T2DM. The current study was designed to examine these relationships. Nocturia was defined as two or more voids per night. Central hemodynamic parameters were assessed from ambulatory BP measurements. In addition to routine biochemistry, 24-h urine collection was performed to measure protein, albumin, and sodium excretion. 158 patients (52.3%) had T2DM and 144 (47.7%) did not have T2DM (control group). The presence of T2DM was independently related with nocturia. Both in whole group and in T2DM patients, most of the hemodynamic parameters are higher in patients with nocturia compared to patients without nocturia. Among patients with T2DM, nocturia was associated with augmentation index and pulse wave velocity. In conclusion, central hemodynamic parameters and markers of vascular stiffness may be related with nocturia in patients with T2DM.

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Effects of Diabetes on Female Voiding Behavior

Abstract: Diabetes significantly altered voiding patterns in a significant proportion of women treated at the diabetic clinic. Peripheral neuropathy is an important factor associated with diabetic voiding dysfunction.

Cited by 88 publications

References 15 publications

Detrusor overactivity in diabetic and non-diabetic patients: is there a difference?

Detrusor overactivity in diabetic and non-diabetic patients: is there a difference?

Voiding function in obese and type 2 diabetic female rats

Central hemodynamics, vascular stiffness, and nocturia in patients with type 2 diabetes

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