Effects of diabetes on female voiding behavior.
OBJECTIVE
We studied voiding behavior in women with type 2 diabetes vs nondiabetic female controls and examined factors associated with voiding dysfunction in patients with diabetes.


METHODS
After eliminating coexisting medical factors that could affect voiding function we evaluated voiding behaviors in 194 female patients with diabetes treated regularly at a diabetic clinic and 162 control women using a lower urinary tract symptom questionnaire based mainly on the American Urological Association Symptom Index questionnaire and free flow analyses with post-void residual urine estimates. Emptying efficiency was defined as 100% x volume voided/(volume voided + post-void residual urine).


RESULTS
Compared with controls patients with diabetes had significantly higher nocturia scores (p = 0.003), weaker urinary streams (p = 0.02), less voided volumes (220 +/- 97 vs 280 +/- 104 ml, p = 0.04) and lower maximal flow rates (19.4 +/- 8.4 vs 25.9 +/- 8.5 ml per second, p <0.001). Remarkable residual urine (100 ml or greater) was detected in 1.8% of controls vs 13.9% of patients. After controlling for age and voided volume diabetes was significantly associated with a decrease in baseline maximum flow of 4.5 ml per second (95% CI 2.9 to 6.2). In patients with diabetes peripheral neuropathy was an independent factor associated with the decrease in emptying efficiency (p = 0.03).


CONCLUSIONS
Diabetes significantly altered voiding patterns in a significant proportion of women treated at the diabetic clinic. Peripheral neuropathy is an important factor associated with diabetic voiding dysfunction.
Departments of Urology and Internal Medicine, College of Medicine, National Taiwan University and Taipei Municipal Hoping Hospital, 7 Chungshan South Road, Taipei, Taiwan.
Wei-Chia
WC
Lee
Huey-Peir
HP
Wu
Tong-Yuan
TY
Tai
Shih-Ping
SP
Liu
Jun
J
Chen
Hong-Jeng
HJ
Yu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000150:complications; D005260:Female; D006801:Humans; D008875:Middle Aged; D014554:Urination; D014555:Urination Disorders / Q000175:diagnosis / Q000209:etiology; D014556:Urine; D014563:Urodynamics