Urologic problems that affect men and women with diabetes include bladder problems and urinary tract infections.
Bladder Problems
Many events or conditions can damage nerves that control bladder function,
including diabetes and other diseases, injuries, and infections. More than half
of men and women with diabetes have bladder dysfunction because of damage to
nerves that control bladder function. Bladder dysfunction can have a profound
effect on a person's quality of life. Common bladder problems in men and women
with diabetes include the following:
Overactive bladder. Damaged nerves may send signals to the bladder at the
wrong time, causing its muscles to squeeze without warning. The symptoms of
overactive bladder include
urinary frequency—urination eight or more times a day or two or more times
a night
urinary urgency—the sudden, strong need to urinate immediately
urge incontinence—leakage of urine that follows a sudden, strong urge to
urinate
Poor control of sphincter muscles. Sphincter muscles surround the
urethra—the tube that carries urine from the bladder to the outside of the
body—and keep it closed to hold urine in the bladder. If the nerves to the
sphincter muscles are damaged, the muscles may become loose and allow leakage or
stay tight when a person is trying to release urine.
Urine retention. For some people, nerve damage keeps their bladder muscles
from getting the message that it is time to urinate or makes the muscles too
weak to completely empty the bladder. If the bladder becomes too full, urine may
back up and the increasing pressure may damage the kidneys. If urine remains in
the body too long, an infection can develop in the kidneys or bladder. Urine
retention may also lead to overflow incontinence—leakage of urine when the
bladder is full and does not empty properly.
Diagnosis of bladder problems
Diagnosis of bladder problems may involve checking both bladder function and
the appearance of the bladder's interior. Tests may include x rays, urodynamic
testing to evaluate bladder function, and cystoscopy, a test that uses a device
called a cystoscope to view the inside of the bladder.
Treatment of bladder problems
Treatment of bladder problems due to nerve damage depends on the specific
problem. If the main problem is urine retention, treatment may involve
medication to promote better bladder emptying and a practice called timed
voiding—urinating on a schedule—to promote more efficient urination. Sometimes
people 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,
strengthening muscles with Kegel exercises, or surgery can help. Treatment for
the urinary urgency and frequency of overactive bladder may involve medications,
timed voiding, Kegel exercises, and surgery in some cases.
Urinary Tract Infections
Infections can occur when bacteria, usually from
the digestive system, reach
the urinary tract. If bacteria are growing in the urethra, the infection is
called urethritis. The bacteria may travel up the urinary tract and cause a
bladder infection, called cystitis. An untreated infection may go farther into
the body and cause pyelonephritis, a kidney infection. Some people have chronic
or recurrent urinary tract infections. Symptoms of urinary tract infections can
include
a frequent urge to urinate
pain or burning in the bladder or urethra during urination
cloudy or reddish urine
in women, pressure above the pubic bone
in men, a feeling of fullness in the rectum
If the infection is in the kidneys, a person may have nausea, feel pain in
the back or side, and have a fever. Frequent urination can be a sign of high
blood glucose, so results from recent blood glucose monitoring should be
evaluated.
The health care provider will ask for a urine sample, which will be analyzed
for bacteria and pus. Additional tests may be done if the patient has frequent
urinary tract infections. An ultrasound exam provides images from the echo
patterns of sound waves bounced back from internal organs. An intravenous
pyelogram uses a special dye to enhance x-ray images of the urinary tract.
Cystoscopy might be performed.
Early diagnosis and treatment are important to prevent more serious
infections. To clear up a urinary tract infection, the health care provider will
probably prescribe antibiotic treatment based on the type of bacteria in the
urine. Kidney infections are more serious and may require several weeks of
antibiotic treatment. Drinking plenty of fluids will help prevent another
infection.
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
Kidney infection (pyelonephritis) usually is caused from bacteria that have spread from the bladder from a UTI (urinary tract infection), poor hygiene, sexual intercourse, pregnancy, catheter, cystoscope exam, surgery, kidney stones, or prostate enlargement. Symptoms of kidney infection include: back pain, frequent urination, pain during urination, fever, and or pus or blood in the urine. Kidney infection is usually treated with antibiotics.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
E. coli is the most common cause of bladder infections. Bladder infection symptoms and signs include frequent urination, burning urination, and foul smelling urine. Mild bladder infections may go away by increasing one's intake of fluid. More severe infections may be treated with a few days of antibiotics.
Impotence, also known as erectile dysfunction, is a common
problem among men characterized by the consistent inability to sustain an
erection sufficient for sexual intercourse or the inability to achieve
ejaculation, or both. Impotence can have emotional causes but most often it is
due to a physical problem.
Overactive bladder is a sudden involuntary contraction of the muscle wall of the bladder causing urinary urgency (an immediate unstoppable need to urinate). Overactive bladder is is a form of urinary incontinence. Treatment options may include Kegel exercises, biofeedback, vaginal weight training, pelvic floor electrical stimulation, behavioral therapy, and medications.
Infertility is the diminished ability to conceive a child. The primary cause of infertility in men is a sperm disorder. In women, the primary cause of infertility is an ovulation disorder. Most forms of infertility can be treated. Conventional infertility therapies include drugs or surgery.
Male sexual dysfunction can be caused by physical or psychological problems. Common sexual problems in men include erectile dysfunction (impotence or ED), premature ejaculation and loss of libido. Treatment for sexual dysfunction in men may involve medication, hormone therapy, psychological therapy, and the use of mechanical aids.
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Managing your diabetes is important. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information is also provided in this article.
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