The association between urodynamic findings and microvascular complications in patients with long-term type 2 diabetes but without voiding symptoms

Diabetic cystopathy is a common complication of diabetes mellitus, which is assessable by urodynamic study. The purpose of this study was to determine the association between urodynamic findings and microvascular complications (neuropathy, retinopathy, nephropathy) in patients with long-term type 2 diabetes but without voiding symptoms. A total of 66 consecutive patients (26 males and 40 females, age 57.00+/-9.50 years, diabetes duration 14.44+/-6.78 years) with documented type 2 diabetes, low scores at the International Prostate Symptom Score (IPSS) and no subjective complaint of voiding problems were included in the study. Seven urodynamic parameters were considered: detrusor activity, bladder capacity, bladder compliance, first sensation of filling, flow rate, bladder outlet status and post-voiding residue. The following independent associations were found: between female sex and increased bladder capacity (p=0.004), between male sex and both decreased bladder compliance (p=0.023) and bladder outlet obstruction (p=0.001), between old age and both low flow rate (p=0.022) and outlet obstruction (p=0.047), between detrusor instability and shorter duration of diabetes (p=0.044) and between peripheral somatic neuropathy and low flow rate (OR=5.208; 95%CI=1.277-21.277). The Spearman's correlation coefficient for the latter association was 0.356 (p=0.005) and remained significant even after controlling for age, sex, HbA1c and diabetes duration (rho=0.310; p=0.019). In conclusion, searching for microvascular complications might be used to screen for some components of diabetic cystopathy in its asymptomatic phase.