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Diabetes Mellitus

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Handbook of Neurourology

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Abstract

Changes in environmental and behavioral factors such as a sedentary life style and obesity over the previous years have resulted in a dramatic increase in the incidence of diabetes worldwide. Urological manifestations of Diabetic patients include: diabetic nephropathy, renal vascular disease, urinary tract infections, emphysematous complications, infertility, erectile dysfunction, and diabetic bladder dysfunction which we will talk about it in details in this section. The most common and bothersome lower urinary tract complication of diabetes mellitus is diabetic bladder dysfunction (DBD). Although DBD is not life threatening, it affects quality of life substantially.

Many theories were implicated to cause lower urinary tract symptoms to be more frequently in diabetes mellitus [DM] which will be discussed in this chapter. These symptoms may start early in diabetes disease even when urinary bladder is still compensating due to osmotic diuresis and polyuria which present mainly as storage symptoms. Underactive urinary bladder usually happens after a chronic exposure of high levels of glucose and oxidative stress which present as voiding symptoms.

Estimates of the prevalence of bladder dysfunction is 43–87% of type 1 diabetic patients and 25% of type 2 diabetic patients, a higher rate than that of widely recognized complications such as nephropathy, which affects less than 50% of patients. Yet, the treatment modalities of DBD are limited.

Understanding DBD pathogenesis is important for development of correct and new options of treatment. Bladder dysfunction can involve different degrees and combinations of diminished bladder filling sensation and poor contractility, which results in an increased post void residual urine, predisposing to infections, lithiasis, and ultimately more dangerous conditions like renal damage.

A wide variety of treatment options available depending on the presentation and urodynamics findings. It can range from behavioral therapy like diet and blood sugar control to medical and surgical treatment.

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Authors and Affiliations

  1. Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia

    Abdulrahman Almuhrij & Riyad T. Al Mousa

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  1. Abdulrahman Almuhrij
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  1. Department of Urology, China Rehabiliation Research Center Capital Medical University, Beijing, China

    Limin Liao

  2. Department of Urology, University Hospital Innsbruck, Innsbruck, Austria

    Helmut Madersbacher

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Almuhrij, A., Al Mousa, R.T. (2023). Diabetes Mellitus. In: Liao, L., Madersbacher, H. (eds) Handbook of Neurourology. Springer, Singapore. https://doi.org/10.1007/978-981-16-7939-1_67-1

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