Investigation of Urodynamic Characteristics and Bladder Sensory Function in the Early Stages of Diabetic Bladder Dysfunction in Women With Type 2 Diabetes

Lee, Wei‐Chia; Wu, Huey-Peir; Tai, Tong-Yuan; Yu, Hong-Jeng; Chiang, Po‐Hui

doi:10.1016/j.juro.2008.09.021

Cited by 73 publications

(63 citation statements)

References 20 publications

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“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] years. Compared with controls, men with T2DM had a significantly mean ( SD ) higher IPSS, of 6.1 (5.8) vs 4.1 (4.6) ( P < 0.001), an increased of odds ratio (95% confidence interval) of having moderate to severe LUTS of 1.78 (1.12-2.84) ( P = 0.01), greater voiding volume of 376 (177) vs 326 (102) mL ( P = 0.04), a worse IIEF-5 score of 17.3 (6.4) vs 20.0 (3.8) ( P < 0.001), an increased of odds ratio of having moderate to severe ED of 3.5 (2.1-5.8) ( P < 0.001) but a similar maximum flow rate and postvoid residual.…”

Section: Resultsmentioning

confidence: 99%

“…These findings suggest that these patients are at risk of developing decreased bladder sensation, resulting in the loss of desire to void and/or increased bladder compliance in the early stages of DM. Recently, Lee et al [17] showed that impaired Aδ and C fibre afferent pathways were associated with poor emptying function in patients with T2DM and a mean age of 67 years. Whether the emptying function of younger patients with DM and with a larger bladder capacity progresses more quickly with time remains to be determined.…”

Section: Discussionmentioning

confidence: 99%

“…LUTS were classified as mild (IPSS ≤ 7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) After completing the IPSS and IIEF-5 questionnaires, the participants were given 500 mL water and asked to void for uroflowmetry when they felt full (uroflowmeter; Dantec, Glostrup, Denmark). The essential requirements for satisfactory urine flow were a minimum voided volume of 150 mL.…”

Section: Patients Subjects and Methodsmentioning

confidence: 99%

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Type 2 diabetes but not metabolic syndrome is associated with an increased risk of lower urinary tract symptoms and erectile dysfunction in men aged <45 years

et al. 2010

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metabolic syndrome with LUTS and ED was also evaluated. RESULTSThe mean ( SD , range) age of the patients was 38.9 (6.1, 20-45) years and the mean duration of diabetes was 2.8 (3.1, 0.5-20) years. Compared with controls, men with T2DM had a significantly mean ( SD ) higher IPSS, of 6.1 (5.8) vs 4.1 (4.6) ( P < 0.001), an increased of odds ratio (95% confidence interval) of having moderate to severe LUTS of 1.78 (1.12-2.84) ( P = 0.01), greater voiding volume of 376 (177) vs 326 (102) mL ( P = 0.04), a worse IIEF-5 score of 17.3 (6.4) vs 20.0 (3.8) ( P < 0.001), an increased of odds ratio of having moderate to severe ED of 3.5 (2.1-5.8) ( P < 0.001) but a similar maximum flow rate and postvoid residual. The IIEF-5 score was negatively correlated with the IPSS ( P < 0.0001, coefficient = − 0.23, 0.35-0.11) and glycosylated haemoglobin ( P = 0.02, coefficient = − 0.14, 0.26-0.01). In all, 156 (69%) patients met the criteria for metabolic syndrome. The mean age, duration of diabetes, glycosylated haemoglobin, IPSS, voided volume, maximum urinary flow rate and IIEF-5 score were similar between patients with and without metabolic syndrome. CONCLUSIONSMen with T2DM and aged < 45 years had more LUTS but a similar bladder emptying function than the controls. ED was highly prevalent and was associated with the severity of LUTS. Metabolic syndrome did not aggravate the severity of LUTS, emptying function or ED in the early stage of DM. OBJECTIVETo investigate the association of type 2 diabetes mellitus (T2DM) and metabolic syndrome with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in Taiwanese men aged < 45 years.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Patients Subjects and Methodsmentioning

confidence: 99%

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Type 2 diabetes but not metabolic syndrome is associated with an increased risk of lower urinary tract symptoms and erectile dysfunction in men aged <45 years

et al. 2010

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“…DBD is generally characterized by impaired bladder sensation, increased bladder capacity, reduced detrusor contractility, and increased residual volume (RV) [3,4,5,6] that is, detrusor underactivity (DUA) or underactive bladder (UAB). For example, urodynamic diagnosis in women classified about a third of type 2 diabetic patients as having DUA [7]. …”

Section: Introductionmentioning

confidence: 99%

Effects of Silodosin, an α<sub>1A</sub>-Adrenoceptor Antagonist, and Distigmine, an Acetylcholinesterase Inhibitor, and Their Combined Effects on Impaired Voiding Function in Zucker Diabetic Fatty Rats

et al. 2015

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Background/Aims: To evaluate the effects of silodosin (α_1A-adrenoceptor antagonist) and distigmine (acetylcholinesterase inhibitor), alone or in combination, on voiding dysfunction in Zucker diabetic fatty (ZDF) rats, a type 2 diabetes model, by pressure flow study. Methods: Male ZDF rats were anesthetized with urethane and a catheter was implanted into the bladder through the dome. Saline was continuously infused into the bladder at 6 ml/h to induce the micturition reflex. Intravesical pressure and micturition volume were recorded continuously and various urodynamic parameters were calculated using a waveform analysis system. Results: Increased bladder capacity, residual volume, and urethral resistance and decreased maximum detrusor contraction velocity and urine flow rate, considered to be detrusor underactivity-like symptoms, were observed in ZDF rats. Although both silodosin and distigmine improved impaired voiding function, administration of both drugs in combination was more effective than either drug alone. Conclusions: ZDF rats showed symptoms suggestive of detrusor underactivity, and silodosin tended to ameliorate these symptoms in ZDF rats. These results suggested that an α_1A-adrenoceptor antagonists may be effective against the voiding disorder accompanying not only bladder outlet obstruction but also deficiency of bladder function. Moreover, combined administration of an α_1A-adrenoceptor antagonist with an acetylcholinesterase inhibitor may have additive efficacy in clinical use.

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“…Both central and peripheral mechanisms have been implicated; namely, diabetic cerebral vasculopathy and peripheral nerve stimulation as well as changes in the detrusor muscle and urothelium (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

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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Investigation of Urodynamic Characteristics and Bladder Sensory Function in the Early Stages of Diabetic Bladder Dysfunction in Women With Type 2 Diabetes

Cited by 73 publications

References 20 publications

Type 2 diabetes but not metabolic syndrome is associated with an increased risk of lower urinary tract symptoms and erectile dysfunction in men aged <45 years

Type 2 diabetes but not metabolic syndrome is associated with an increased risk of lower urinary tract symptoms and erectile dysfunction in men aged <45 years

Effects of Silodosin, an α<sub>1A</sub>-Adrenoceptor Antagonist, and Distigmine, an Acetylcholinesterase Inhibitor, and Their Combined Effects on Impaired Voiding Function in Zucker Diabetic Fatty Rats

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

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