Urodynamics in Early Diagnosis of Diabetic Bladder Dysfunction in Women: A Systematic Review and Meta-Analysis

BACKGROUND: Urodynamics can detect subtle voiding changes before cystopathy symptoms manifest. The aim of the present study was to assess urodynamic changes in diabetic women. MATERIAL/METHODS: A systematic search was performed on 04 November 2021 to identify studies reporting urodynamic parameters in diabetic women. Data were analyzed in a single-arm meta-analysis due to lack of sufficient studies with direct comparisons to healthy women. For data synthesis, a random-effects model with restricted maximum-likelihood estimation was applied. The calculated effect sizes were visualized in forest plots. Statistical heterogeneity was assessed using the I(2) measure and the χ(2) test. The risk of bias was assessed using the QUIPS tool. PROSPERO ID: CRD42021256275. RESULTS: Out of 1750 records, 10 studies were used in the analysis (n=2342 diabetic women). Pooled event rates showed that mean voided volume was 288.21 mL [95% confidence interval (CI): 217.35–359.06, I(2)=98%], mean postvoid residual volume was 93.67 mL [95% CI: 31.35–155.99, I(2)=100%], mean Q(max) was 18.80 mL/sec [95% CI: 15.27–22.33, I(2)=99%], mean P(det)Q(max) is 30.13 cmH(2)O [95% CI: 25.53–34.73, I(2)=90%], mean first sensation of bladder filling was 178.66 mL [95% CI: 150.59–206.72, I(2)=97%], and mean cystometric capacity was 480.41 mL [95% CI: 409.32–551.50, I(2)=98%] in diabetic women. CONCLUSIONS: Pooled results indicate that diabetic women tend to have a smaller voided volume, slower Q(max) and P(det)Q(max), larger postvoid residual, and higher first sensation of bladder filling and cystometric capacity compared to the general female population.