Lower urinary tract symptoms and uroflowmetry in women with type 2 diabetes mellitus with and without bladder dysfunction.

OBJECTIVES: To study the presence of lower urinary tract symptoms and parameters of uroflowmetry in women with type 2 diabetes mellitus with and without bladder dysfunction versus healthy controls.

METHODS: After eliminating the possible confounders that might cause bladder dysfunction, 182 female patients at a diabetic clinic were evaluated by the American Urological Association Symptom Index (AUA-SI) questionnaire and uroflowmetry with postvoid residual (PVR) urine volume estimate. Their data were compared with the data from 197 healthy women, frequency-matched by age.

RESULTS: Using a cutoff value of bladder voiding efficiency of less than 75% with a PVR greater than 50 mL but less than 100 mL, a PVR greater than 100 mL, or a total volume greater than 500 mL, 47 patients (25.8%) were stratified as having bladder dysfunction. These patients had a significantly greater mean AUA-SI score (mean +/- standard error of the mean 9.6 +/- 0.8, P <0.001), as well as a lower maximum uroflow value (15.2 +/- 1.2 mL/s, P <0.001) compared with the control groups. The odds ratio of each lower urinary tract symptom was significantly greater in this group, except for straining (P = 0.12). A high proportion with an intermittent uroflow pattern (odds ratio 4.42, P <0.001) was also noted. Compared with the healthy controls, the diabetic women had no bladder dysfunction and seemed unaffected by the lower urinary tract symptoms as defined by the AUA-SI scoring system, with the exception of nocturia (odds ratio 2.62, P = 0.006).

CONCLUSIONS: Women with diabetes may have an increased risk of nocturia even without bladder dysfunction. A high AUA-SI score and lower maximum uroflow are likely to be good markers for diabetic bladder dysfunction.