The association between urodynamic findings and micro-vascular complications in type 2 diabetic patients with or without voiding symptoms

Abstract

The aim of the present study was to evaluate the association between diabetic micro-vascular complications with the varied urodynamic manifestations of diabetic cystopathy in both asymptomatic and symptomatic subgroup of patients as shown in previous studies. A total of 63 type 2 diabetic patients are stratified into those with and without voiding dysfunction according to International Prostate Symptom Score (IPSS) score. Urine for albumin/creatinine ratio, direct ophthalmoscopy, and nerve conduction study (NCS) along with multichannel urodynamic study (UDS) were performed to detect diabetic micro-vascular complications. Correlation between urodynamic and micro-vascular complications was evaluated in patients with and without voiding symptoms and compared. Among the 63 patients (34 patients asymptomatic and 29 patients symptomatic), diabetic nephropathy, diabetic retinopathy, motor conduction study (MCS) abnormality, sensory conduction study (SCS) abnormality, and combined NCS abnormality were seen in 74.6, 49.2, 66.7, 65.1, and 65.1 % patients, respectively. On urodynamic study, diabetic cystopathy motor (DCM), diabetic cystopathy sensory (DCS), detrusor overactivity (DO), and bladder outlet obstruction (BOO) were found in 58.7, 54, 34.9, and 36.5 % cases, respectively. Among the micro-vascular complications, sensory nerve conduction studies (SCS), motor nerve conduction studies (MCS), and combined NCS abnormality had significant association with UDS abnormalities in diabetic patients. The association was stronger in symptomatic patients. A large proportion of type 2 diabetic patients have shown clinical and electrophysiologic evidence of neurologic dysfunction which can predict the presence or absence of DCS and DCM even in the asymptomatic stage. The correlation is stronger in the symptomatic group.