[Diabetic neurocystopathy: multivariate study].
OBJECTIVE
To analyze the prevalence of urodynamic disorders and the factors associated with bladder instability in patients with diabetes mellitus.


METHODS
We conducted a clinical and urodynamic study on 138 diabetic patients (71 males, 51%; 67 females, 49%) with a mean age of 64.04 years. Patient evaluation included patient history, neurological physical examination, cystometry, pressure-flow test, filling videocystography and selective EMG of the periurethral sphincter. Data obtained were analyzed by multivariant logistic regression analysis, taking the probability of developing bladder instability as a dependent variable.


RESULTS
Bladder instability was the most frequent urodynamic finding (52%), followed by lower urinary tract obstruction (44%), involvement of bladder contractility (41%) and stress urinary incontinence (22%). Lower motor neuron (S2-S4) pudendal nerve lesion was observed in 33% of the cases and 24% had upper motor neuron involvement. Multivariant analysis showed age and stress urinary incontinence (inverse correlation) to be the only independent variables for bladder instability. The other variables that correlated with instability (but dependent on the foregoing variables) were involvement of bladder contractility and type of diabetes (higher probability for diabetes type II). No correlation was found for sex, duration of the diabetes, stroke (CVA), urinary obstruction or pudendal nerve lesion.


CONCLUSIONS
Bladder instability was found to be the most frequent urodynamic disorder in diabetic patients. The probability of developing bladder instability increases with age and decreases in patients with stress urinary incontinence.
Salinas Casado
J
J
Servicio de Urología, Hospital Clínico Universitario San Carlos, Universidad Complutense, Madrid, España.
Virseda Chamorro
M
M
Adot Zurbano
J M
JM
Teba del Pino
F
F
Arredondo Martínez
F
F
Hernández Lao
A
A
Fernández Lucas
C
C
Herrero Payo
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012044:Regression Analysis; D001745:Urinary Bladder Diseases / Q000453:epidemiology / Q000503:physiopathology*