Storage symptoms more severe in men with comorbid diabetes

By Joanna Lyford, Senior medwireNews Reporter

A study of men with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) suggests that the presence of comorbid diabetes is associated with more severe urological symptoms.

Specifically, men with Type 2 diabetes had greater urinary frequency and nocturia than their nondiabetic counterparts, a difference that the authors say warrants further study.

Kang Su Cho (Yonsei University College of Medicine, Seoul, South Korea) and team analysed information on 278 elderly men newly diagnosed with LUTS over a 2-year period, of whom 139 had a pre-existing diagnosis of Type 2 diabetes. Men with and without diabetes were matched for age and prostate volume using propensity scoring.

The men’s mean age was 65.3 years, the mean prostate volume was 35.1 mL and mean total scores on the International Prostate Symptom Score and Overactive Bladder Symptom Score were 16.83 and 5.07, respectively.

Writing in Urology, Cho and co-authors report that there were no differences in age, prostate volume, transitional zone volume, prostate-specific antigen level, voided volume or maximum flow rate between the diabetes and control groups. By contrast, residual urine volume was significantly higher in the diabetes group than in controls, at 29.34 mL versus 22.45 mL.

The total IPSS score was significantly higher in diabetes patients than controls (17.80 vs 15.88), a difference that was driven by higher IPSS storage symptom scores (7.45 vs 6.58) and postmicturition symptom scores (2.57 vs 2.19) in men with diabetes.

Among the storage symptoms, the diabetes group scored significantly higher for frequency and nocturia, whereas urgency did not differ between the groups.

The OABSS total score was significantly higher in diabetes patients than controls (5.62 vs 4.54), with this difference being entirely driven by a higher nocturia score in those with diabetes (2.14 vs 1.71). The other subscales did not differ between the groups.

Cho and colleagues remark that diabetes mellitus is a well-known risk factor for LUTS, whereas studies have reported conflicting results regarding whether diabetes can cause overactive bladder.

Noting that findings from the present study imply that the greater frequency and nocturia in the diabetes group may be because of polyuria rather than reduced bladder capacity, the authors conclude: “[U]rodynamic results would be useful to obtain in future studies to provide objective evidence to support and understand our current observations.”

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