Diabetes and the bladder

Bladder complications that follow diabetes occur as a result of damage to the nerves and blood vessels in the region as occurs elsewhere in the body due to high blood sugar levels. Urinary tract infections and bladder problems occur more often in people with, than in people without diabetes.
People with diabetes who keep their blood sugar levels under control almost always have a greatly reduced risk of developing bladder problems. Symptoms of urinary tract infection include an urge to urinate which is frequent, pain or burning sensation in the bladder while urinating and cloudy or reddish urine.

Continue after the cut..

The bladder problems common in men and women with diabetes include what is referred to as overactive bladder, poor control of the muscles at the neck of the bladder that help to keep the bladder shut or open when necessary, and urine retention.
Those with overactive bladders experience very frequent urination of eight or more times during the day and two or more times at night even when the blood sugar is well controlled. Other symptom they may experience is urgency, which is a sudden and strong need to urinate immediately and incontinence which is leakage of urine that follows a sudden and strong urge to urinate.
In those with poor control of the muscles at the neck of the bladder, the muscles may become loose and allow leakage of urine or stay tight when a person is trying to release urine and thus will experience inability to urinate. In those with urine retention, the nerves to the muscles of the bladder are damaged, thus the muscles of the bladder are unable to contract as they should to force urine out of the bladder, subsequently, urine will accumulate in great amounts such that the bladder will swell up to reach the level of the navel!
This urine buildup will eventually lead to what is called backpressure effects which will result in kidney damage. Also, the accumulated urine in the bladder can become infected by bacteria and lead to abdominal pain and fever. Eventually such an overfilled bladder will start leaking urine, this is referred to as overflow incontinence. Visits to doctors called urologists who specialize in the treatment of problems of the urinary system are essential in people with bladder problems.
The type of treatment offered will vary depending on the type of bladder problem at hand. In those with urine retention, some drugs that help the bladder to contract well will be given. Also, the person and relatives will be taught about timed voiding, which is urinating at particular times whether the person feels the need to urinate or not. Some may require the insertion of a tube called a catheter into their bladder from time to time to drain it of urine.
Massaging the lower abdomen to help bladder emptying has also been found helpful in emptying the bladder. In those with urine leakage and an overactive bladder; surgery, medications or exercises of the muscles of the pelvic region called Kegel exercises are helpful.
One paradox that people with diabetes and those that care for them must be aware of is that as the duration of diabetes increases and bladder damage ensues, frequency of urination actually reduces.
Hence, in the presence of very elevated blood sugar levels, excessive urination which usually follows such high blood sugar levels will not occur, this is why using the rate of frequency of urination as a guide to the level of blood sugar control is unhelpful at this stage. The best method of measuring diabetes control is by doing blood tests.

Dr Olubiyi Adesina
Consultant Diabetologist
e-mail: fbadesina@yahoo.com
08034712568

Share your thoughts...thanks!