Evaluation of urodynamic pattern in short and long-standing diabetic patients

Haytham Elsakka; Ahmed Ibrahim; Abdulghani Khogeer; Adel Elatreisy; Rawan Elabbady; Osama Shalkamy; Ayesha Khan; Iman Sadri; Ahmad AlShammari; Ahmad Khalifa; Serge  Carrier; Melanie Aube-Peterkin

doi:10.4081/aiua.2023.11072

Authors

Haytham Elsakka Urology Department, East Lancashire Hospitals NHS trust, Balckburn, Lancashire, United Kingdom. https://orcid.org/0000-0002-5403-3874
Ahmed Ibrahim
eldemerdash90@gmail.com
Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada. https://orcid.org/0000-0002-2769-2559
Abdulghani Khogeer Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC; Department of Surgery, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia, Canada. https://orcid.org/0000-0002-6995-8132
Adel Elatreisy Urology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. https://orcid.org/0000-0001-8407-0564
Rawan Elabbady Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada. https://orcid.org/0000-0002-1829-9157
Osama Shalkamy Urology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ayesha Khan Urology Department, East Lancashire Hospitals NHS trust, Balckburn, Lancashire, United Kingdom. https://orcid.org/0000-0001-9978-3110
Iman Sadri Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada.
Ahmad AlShammari Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada.
Ahmad Khalifa Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada. https://orcid.org/0000-0003-1376-5697
Serge Carrier Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada. https://orcid.org/0000-0002-7179-8190
Melanie Aube-Peterkin Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada.

Purpose: To address the pattern of urodynamic findings in diabetic patients with lower urinary tract symptoms (LUTS), comparing short-standing and long-standing type 2 diabetes mellitus (T2DM).

Methods: A prospective study was conducted on 50 patients presenting with LUTS and a concurrent diagnosis of T2DM, between February 2016 and May 2018. Patients were classified and evaluated according to the duration of diabetes into two groups: short-standing DM (< 15 years, n = 31), and long-standing DM (≥ 15 years, n = 19) groups. The impact of LUTS and quality of life were assessed in female patients using ICIQ-FLUTS and male patients using ICIQ-MLUTS.

Results: A total of 50 patients were included in the study. The mean duration of T2DM was 10 ± 0.7 years. The mean age was 56.3 ± 1.2 years, and the mean HbA1c was 7.5 ± 1.2%. Urodynamic evaluation detected significantly higher detrusor overactivity (DO) and increased bladder sensation with the short-standing DM group (35.5 vs. 15.8%, p = 0.01 and 32.3 vs. 5.3%, p = 0.01, respectively). Comparatively, weak, or absent detrusor contractility were more frequent in patients with long-standing DM (52% and 26% respectively p = 0.01). As expected, overflow incontinence and straining during voiding were significantly higher in the long-standing DM group (p = 0.04 and p = 0.03, respectively). Surprisingly, there was no significant correlation between patients presenting with urgency in their voiding diary (subjective) and urodynamic detection of DO (p = 0.07).

Conclusions: There are different patterns in urodynamic characterizations of T2DM. Patients with short-standing DM present more commonly with storage symptoms and detrusor overactivity on urodynamics. Contrastingly, patients with long-standing DM present more frequently with voiding symptoms and detrusor underactivity on urodynamics. Thus, screening for an underactive bladder is advisable in patients with long-standing T2DM.

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Elsakka, H., Ibrahim, A., Khogeer, A., Elatreisy, A., Elabbady, R., Shalkamy, O., Khan, A., Sadri, I., AlShammari, A., Khalifa, A., Carrier, S., & Aube-Peterkin, M. (2023). Evaluation of urodynamic pattern in short and long-standing diabetic patients. Archivio Italiano Di Urologia E Andrologia, 95(1). https://doi.org/10.4081/aiua.2023.11072