URODYNAMIC CHARACTERISTICS IN DIABETIC PATIENTS WITH LOWER URINARY TRACT VOIDING DYSFUNCTION AT UNIVERSITY MEDICAL CENTER HO CHI MINH CITY
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Abstract
Background: Lower urinary tract dysfunction (LUTD) is a multifactorial clinical syndrome commonly found in patients with diabetes mellitus (DM), with a prevalence ranging from 43% to 87% according to classical studies. Among these, voiding dysfunction poses a high risk as it can lead to severe complications, including chronic urinary retention, recurrent urinary tract infections, hydronephrosis, and renal failure. Urodynamic study (UDS) remains the gold standard for accurately differentiating whether impaired voiding is caused by detrusor underactivity or bladder outlet obstruction. This study aims to analyze specialized UDS parameters to clarify the underlying nature and severity of voiding dysfunction in diabetic patients.
Methods: A retrospective case series was conducted at the Department of Functional Urology, University Medical Center Ho Chi Minh City, from January 2024 to March 2026. The study included patients with type 2 diabetes mellitus presenting with voiding symptoms according to International Continence Society (ICS) definitions. All subjects were indicated for and underwent pressure-flow studies (PFS) following standardized ICS protocols. Principal urodynamic parameters were recorded and analyzed to assess voiding function.
Results: A total of 81 patients (26 males, 55 females) were analyzed. The mean age was 69 ± 12.8 (20–95) years; the mean duration of DM was 11.6 ± 8.7 (1–31) years; and the mean HbA1c level was 8.1 ± 2 (5.8–13.9). Key urodynamic parameters showed: maximum cystometric capacity (Vmax) of 435 ± 190.6 (70–750) mL; post-void residual (PVR) of 222.9 ± 219 (0–750) mL; and maximum flow rate (Qmax) of 7 ± 6 (0–35) mL/s. Low bladder compliance was observed in 22.2% of cases. Detrusor underactivity (DU) was the predominant finding (55,6%), followed by bladder outlet obstruction (BOO) in 24.7%, and a combined pattern (DU+BOO) in 1,2%.
Conclusion: Voiding dysfunction in diabetic patients is characterized by a diverse pathophysiology. While detrusor underactivity remains the predominant finding, the significant prevalence of bladder outlet obstruction and mixed patterns underscores the pivotal role of urodynamic studies in precise classification and the individualization of treatment strategies.
Keywords
Diabetes Mellitus, Urodynamics, Voiding Dysfunction
Article Details
References
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