Working With Your Urologist To Treat Diabetes-Related Bladder Problems
Diabetes is a disease that can cause a wide range of debilitating side effects and related conditions, and the bladder of a diabetic person is vulnerable to a variety of problems. However, with proper management of your diabetes, and with proper medical help and supervision of your bladder functions by a urologist, the risk of developing these conditions can be minimised and more easily treated if you are still unlucky enough to be affected by them.
Which bladder conditions are associated with diabetes?
A variety of bladder complaints can be provoked or exacerbated by diabetes:
- Infection - Diabetes reduces the effectiveness of the urinary system's ability to fight off pathogens and can leave a diabetic person more vulnerable to urinary tract infections.
- Urine retention - Diabetes also causes damage to nerves in various parts of the body, including the bladder. This loss of nervous sensation reduces the bladder's ability to signal to the brain that it is full and requires emptying, resulting in the retention of large amounts of urine. Diabetic people suffering from urine retention will go to the toilet more infrequently and for longer periods, and may have trouble emptying their bladder fully in a single visit.
- Incontinence - This can be caused by nerve damage to the sphincters that control urine flow, or by loss of muscle control of the bladder as the muscles are stretched and weakened by excessive urine retention. Nerve damage can also reduce the intensity of the urge to urinate, resulting in more 'near-misses'.
- Over-active bladder - Conversely, if the nerves that control the bladder muscles are damaged, they can compel the bladder muscles to spasm uncontrollably. This can result in sudden, painful urges to urinate and may progress into incontinence.
How can my diabetes-related bladder problems be treated?
The first step of resolving any bladder dysfunction a diabetic person may experience is a visit to the doctor, who will probably refer you to a urology clinic for a more thorough examination of your condition. If possible, you should visit a urologist with experience of treating bladder problems in diabetic people.
Once your condition has been assessed, and the extent of your bladder problems ascertained, you may be offered one or more of the following treatment options:
- Antibiotics - If you are suffering from a urinary tract infection caused or exacerbated by diabetes, you will be prescribed antibiotics to fight the infection. These antibiotics can take days or weeks to fight off the infection, depending on its severity. You will be advised on how to time your antibiotics to coincide with your eating patterns, especially if you are on a heavily restricted, low-glucose diet.
- Pelvic floor exercises - Also known as Kegel exercises, these exercises strengthen the muscles of the pelvic floor that help to control urination. Your doctor or urologist may put together a series of exercises for you to perform yourself, which can significantly increase bladder control in milder cases of incontinence. If your pelvic floor muscles have weakened too much for you to effectively control them, you may be provided with an electrical muscle stimulator to assist you.
- Medication - Certain medications are sometimes used to treat urine retention and incontinence, and they work by strengthening the muscles that control the urethra, allowing a diabetic person with a distended or over-active bladder to halt urination for longer.
- Surgery - If less invasive treatments fail to provide a solution, your urologist may recommend surgery. Depending on your needs, your gender and the nature of your diabetes and bladder problems, this can take one of several forms. In some cases, an artificial replacement sphincter is surgically inserted to allow you more bladder control, while in others electrical nerve stimulators are attached to the nerves of the urinary tract, increasing effective communication with the brain. Ensure that you consult your urologist thoroughly on the potential risks and benefits of any procedure they recommend.