Bladder Disorders in Diabetes

DEFINITION

• Bladder dysfunction in diabetes mellitus (DM) spans a spectrum from lower urinary tract symptoms (LUTS) such as incontinence to bladder cystopathy.
• Detrusor muscle, neurologic, and urothelial dysfunction underlie bladder dysfunction in DM.
• Urge incontinence: involuntary loss of urine while feeling a need to urinate. Usually due to neurogenic detrusor overactivity (i.e., spastic bladder)
• Stress incontinence: involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise. Usually due to weak pelvic floor muscles.
• Bladder cystopathy: decreased bladder sensation and contractility resulting in urinary retention, the most severe bladder disorder in DM. Usually due to autonomic neuropathy (also known as neurogenic bladder).