Prevalence of Diabetic Neurogenic Bladder and Its Association with Gynecological, Renal, and Peri-Anesthetic Risk Factors Among Women with Diabetes Mellitus: A Community-Based Cross-Sectional Study

Abstract

Background: Diabetic neurogenic bladder is an underrecognized complication of diabetes mellitus that may lead to urinary urgency, incontinence, incomplete bladder emptying, recurrent infection, and perioperative urinary retention. This study determined its prevalence and associated gynecological, renal, and peri-anesthetic factors among women with diabetes mellitus.

Material and Methods: This community-based cross-sectional study included 120 women with diabetes mellitus recruited from the Department of Obstetrics and Gynecology, Hameed Latif Hospital, Lahore, and the Department of Anesthesia, Lahore General Hospital, from August 2022 to July 2023. Demographic, diabetic, gynecological, renal, neurological, urinary, and peri-anesthetic data were recorded. Lower urinary tract symptoms, postvoid residual urine, uroflowmetry findings, and peripheral neuropathy were assessed. Multivariable logistic regression identified independent associated factors.

Results: Diabetic neurogenic bladder was identified in 43 participants, giving a prevalence of 35.8%. Affected women had longer diabetes duration, higher glycated hemoglobin, more frequent peripheral neuropathy, greater postvoid residual urine, and lower maximum urinary flow rates. Nocturia, urgency, incomplete emptying, weak urinary stream, and urgency incontinence were the commonest symptoms. Diabetes duration of at least 10 years, glycated hemoglobin of at least 8.5%, peripheral neuropathy, albuminuria, and previous postoperative urinary retention remained independently associated with bladder dysfunction.

Conclusion: Diabetic neurogenic bladder affected more than one-third of women with diabetes in this study population. Routine urinary symptom screening, glycemic optimization, postvoid residual measurement, and targeted referral may improve early detection and reduce renal, infectious, and perioperative complications.

Keywords: Diabetes mellitus; diabetic neurogenic bladder; urinary retention; peripheral neuropathy; albuminuria; women