Author: Nancy Touchette, PhD
Source: The Diabetes Problem Solver, American Diabetes Association
Autonomic neuropathy can cause problems with bladder control. Three different types of nerves control how your bladder functions. Your bladder serves as a sort of vessel to hold the urine that your kidneys make after they have filtered the blood. The kidneys filter the blood and send the blood and blood cells back into circulation. The waste products are collected in the urine, which is sent to the bladder until it is eliminated from the body. The bladder can expand to hold more and more urine until you feel the urge to urinate. One type of nerve sends a message to your brain when your bladder is full and your brain tells you to go to the bathroom. Another type of nerve causes your bladder to contract to push the urine out. A third type of nerve controls the sphincter muscle of the bladder. This muscle opens to allow you to urinate and closes when you are finished. Damage to any of these nerves can cause problems with the way the bladder functions and with the way you urinate. This type of problem is often called bladder neuropathy, bladder dysfunction, or neurogenic bladder.
The symptoms of neurogenic bladder depend on which nerves are damaged. You might find that you feel the need to urinate less often, have difficulty completely emptying your bladder, have a weak urinary stream, find it difficult to start urinating and may dribble afterwards, experience urinary incontinence, find it difficult to wait to urinate once you feel the need, or develop frequent urinary tract infections. The symptoms of a urinary tract infection include a frequent need to urinate even though you may not void much urine each time, pain or burning when you urinate, being unable to expel any urine even though you feel the urge, or discolored urine.
Your best bet in avoiding bladder problems is to take steps to prevent neuropathy from occurring in the first place or to delay its onset. This includes keeping your blood glucose levels under tight control, avoiding alcohol and smoking, exercising regularly, and keeping your weight under control.
WHAT TO DO
If you have any of the symptoms of bladder neuropathy, talk to your doctor about what you can do to alleviate the problem. If you have symptoms of a urinary tract infection, talk to your doctor at once. If left untreated, urinary tract infections can cause damage to the kidneys.