Clinical significance of diabetes mellitus on detrusor functionality on stress urinary incontinent women without bladder outlet obstruction

Introduction and hypothesis: Our aim was to evaluate the effect of diabetes mellitus (DM) on detrusor contractility (DC) in women without bladder outlet obstruction (BOO) by using urodynamic study (UDS). Methods: We reviewed the clinical records of 863 consecutive women without BOO, each of whom was diagnosed with stress urinary incontinence (SUI) by UDS. Uroflowmetry measurements included maximal flow rate (Q_max), time to Q_max, voided volume, and postvoid residual urine volume (PVR). Data from filling cystometry included the first strong desire to void and the Valsalva leak-point pressure (VLPP). For voiding cystometry data, detrusor pressure at Q_max (P_det@Q_max) and bladder contractility index (BCI) were analyzed. In the DM group, the level of glycosylated hemoglobin (HbA_1c) and DM duration were measured. Results: After the application of exclusion criteria, complete UDS data of 708 patients were available. The cohort was divided into two groups according to DM status. The DM group comprised 92 (12.9 %) patients, the non-DM group 616 (87.0 %). Mean maximal flow rate and P_det@Q_max and bladder contractility index were lower in the DM group, in whom mean DM duration was 9.24 ± 7.63 years and mean HbA_1c level 7.27 ± 1.43 %. DM duration was significantly correlated with Q_max (−0.309, p = 0.003), P_det@Q_max (−0.369, p < 0.001), and BCI (−0.409, p < 0.001). Moreover, the HbA_1c level was significantly correlated with Q_max (−0.256, p = 0.016), P_det@Q_max (−0.231, p = 0.026), and BCI (−0.308, p = 0.002). Conclusions: Our UDS data revealed that DM is associated with impaired DC in women without BOO. Moreover, longer DM duration and poor glycemic control were associated with impaired DC.