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KMID : 0358319970380020185
Korean Journal of Urology
1997 Volume.38 No. 2 p.185 ~ p.191
Usefulness of Urodynamic Study in Diabetic Cystopathy



Abstract
Sixty diabetic cystopathy patients(symptomatic DCP, 4.9%) among 1236 patients of diabetes mellitus(DM) from May, 1995 to June, 1996 were analyzed to ascertain the usefulness of urodynamic study in the diagnosis of DCP. The mean age was 58 (24~80)
years
and mean duration of DM was 9(1~30) years. 36(60%) patients had diabetic neuropathy, 31 (52%) had diabetic retinopathy ad 4( 7%) had diabetic nephropathy. DM was managed by insulin pump (DIABECARETM, 52%) and subcutaneous insulin injection (42%).
In
residual urine and voiding diaries, residual urine volume more than 40ml was 83%, voiding interval less than 2 or more than 5 hours was 67% and voiding amount less than 200ml or more than 400ml was 48%. According to urodynamic findings, patients
were
classified as detrusor areflexia (63%), impaired detrusor contractility (18%), detrusor instability (15%) and normal detrusor contraction(3%). There were no significant differences of age, serum-HbA1C, treatment method and duration of diabetes
mellitus
among above groups. Mean duration of DM in irritative symptom group(32.%), combined symptom group (23%) and obstructive symptom group (45%) were 2 years, 8 years and 15 years respectively (p<0.001). The shape of the cystometrographic curve was
not
influenced by the rate of bladder filling (40ml/min versus 100ml/min).
In conclusion, because DCP is marked by insidious onset and progression with minimal symptoms, DCP can be early diagnosed using urodynamic study especially in patients with voiding symptoms and long DM duration.
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