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Diabetes and Urologic Problems

Bladder dysfunction can have a profound effect on quality of life. Diabetes can damage the nerves that control bladder function. Men and women with diabetes commonly have bladder symptoms that may include a feeling of urinary urgency, frequency, getting up at night to urinate often, or leakage of urine (incontinence).

These symptoms have been called overactive bladder. Less common but more severe bladder symptoms include difficulty urinating and complete failure to empty (retention). These symptoms are called a neurogenic bladder. Some evidence indicates that this problem occurs in both men and women with diabetes at earlier ages than in those without diabetes.

Neurogenic Bladder

In neurogenic bladder, damage to the nerves that go to your bladder can cause it to release urine when you do not intend to urinate, resulting in leakage. Or damage to nerves may prevent your bladder from releasing urine properly and it may be forced back into the kidneys, causing kidney damage or urinary tract infections.

Neurogenic bladder can be caused by diabetes or other diseases, accidents that damage the nerves, or infections.

Symptoms of neurogenic bladder include:

  • urinary tract infections
  • loss of the urge to urinate when the bladder is full
  • leakage of urine
  • inability to empty the bladder

Your doctor will check both your nervous system (your brain and the nerves of the bladder) and the bladder itself. Tests may include x rays and an evaluation of bladder function (urodynamics).

Treatment for neurogenic bladder depends on the specific problem and its cause. If the main problem is retention of urine in the bladder, treatment may involve medication to promote better bladder emptying and behavior changes to promote more efficient urination, called timed urination.

Occasionally, people may need to periodically insert a thin tube called a catheter through the urethra into the bladder to drain the urine. Learning how to tell when the bladder is full and how to massage the lower abdomen to fully empty the bladder can help as well. If urinary leakage is the main problem, medications or surgery can help.

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