Diabetic Bladder: 7 Ways to Handle the Effects of Diabetes on Your Bladder
Has diabetes taken a toll on your bladder and your mental health? Do you know exactly what diabetes does to your bladder, and how to deal with it? Read on for seven things you can potentially do to take greater control over your bladder condition.
What does diabetes do to your bladder: the cause of diabetic bladder
Diabetes, especially when poorly controlled, can lead to neuropathy—a nerve disorder that can affect the feet, hands, and bladder. Excess glucose can inflame nerves and other tissues, which can cause nerve dysfunction, leading to burning, stinging, numbness, tingling, and even pain in severe cases. It is the neuropathy of the bladder, otherwise known as neurogenic bladder, that makes the bladder dysfunctions. When the cause of the neurogenic bladder is specifically diabetes, it can also be called diabetic bladder.
The diabetic bladder can lead to urinary retention. Diabetes has damaged the bladder nerves’ ability to signal when the bladder is full. Once the diabetic bladder develops to an advanced stage, bladder fullness is not sensed until the bladder if overfilled to two or three times its normal size.
Paradoxically, excess glucose in the blood leads to excessive thirst and urination, which make people urinate more frequently because they drink more fluid. Once nerve damage sets in, the sensation to void is diminished, causing the bladder to overfill with urine. The overfilling stretches the muscle in the bladder, which can weaken it leading to decreased contractility. The bladder’s decreased ability to contract leads the incomplete emptying of urine since the bladder doesn’t have enough strength to expel all the fluids out. Retained urine increases the risk of infections, which are more common in people with diabetes in the first place.
Diabetes can cause external urethral sphincter dysfunction. The sphincter is a group of muscles that surrounds the urethra, keeping it shut so urine doesn’t leak out. Usually, when someone urinates, the sphincter muscles relax, and when the person is done, the muscles contract. But when the sphincter muscles’ control is damaged by diabetes, it could either result in urinary retention or urinary incontinence. Diabetes can also impair urethral smooth muscle relaxation, which also obstructs the flow of urine out of the body.
The diabetic bladder can also be overactive: the damaged nerves of the bladder can send wrong signals that make the bladder squeeze and expel fluids without warning.
Common diabetic bladder symptoms:
- Frequent urination
- Urinary urgency—the sensation of needing to urinate urgently.
- Urinary incontinence—involuntary loss of urine
- Urge incontinence—involuntary loss of urine preceded by an overwhelming urge to urinate
- Hesitancy—difficulty starting a urinary stream
- Urinary tract infections (UTI)
- Decreased bladder sensation
- Increased bladder capacity
- Impaired bladder emptying—results in a higher volume of residual urine post urination
The most common urodynamic findings (findings from tests that evaluate bladder function) in diabetic patients show impaired bladder sensation, increased residual urine after voiding, and decreased detrusor (bladder muscle) contractility. Many of the symptoms of diabetic bladder are the same as symptoms caused by diseases that are not diabetes.
7 ways to start dealing with a diabetic bladder
1. Keep a bladder diary
The bladder diary helps you and your doctor keep track of and evaluate the amount and type of fluid you ingested and your voiding (urination) pattern. Your doctor may ask you to keep a bladder diary to start an initial investigation into your bladder condition. You may also be asked to measure and write down the amount of urine retained after the attempt to void. The retained urine is known as post-void residuals (PVR), and a normal level of PVR has not been established. A suggested normal range in older adults is between 50 mL and 150 mL. PVR measurements are taken with an ultrasound immediately after voiding, or by using a catheter to drain and measure residuals.
2. Timed voiding
Schedule your voiding every few hours and stick to it. You may want to discuss the time gap and frequency with your doctor. Help yourself stick to the schedule by setting reminders on your phone. If you have an overactive bladder as a result of diabetes, your doctor may recommend bladder training, which is also about sticking to a voiding schedule even when you feel the urge to urinate.
3. Double voiding
To double void, void once and then repeat in 10-15 minutes. This practice is to help you drain your bladder completely.
4. Bladder massage
To help yourself void completely, you can push your fist/palm into your bladder, which is located in your pelvis, above and behind your pubic bone. Massage and push the urine out with a pressure you feel comfortable with. Do not apply excessive force to the point of discomfort.
5. Pelvic floor exercises
You can do pelvic floor exercises to help yourself control urine flow. Both men and women benefit from the same exercises. Perform pelvic floor exercises daily a couple of times each day with 10 repetitions.
6. Keep your diabetes under control
If your bladder dysfunction is specifically caused by diabetes’ damage to your nerves, then controlling diabetes can have a modest effect on improving your condition. Follow your doctor’s instructions on how to best deal with diabetes.
7. Empty the bladder completely with massage or intermittent catheter
If you suffer from urinary retention as a result of diabetes, you need to empty your bladder completely with a massage or an intermittent catheter. Talk to your doctor to see if you need a catheter. When using a catheter, it is extremely important to have sterile technique, since people with diabetes are at increased risk of infections in general.
If you are diabetic and are concerned about the risk of infection, look for a catheter that is non-touch and pre-lubricated. Non-touch means you don’t have to touch the tube of the catheter during self-catheterization. Touching the tube greatly increased the risk of a catheter-associated urinary tract infection (CAUTI), since germs on your hands can get onto the catheter, which is then introduced into the urethra, causing an infection.
CompactCath provides catheters that are pre-lubricated with silicone oil, 100% touch-free, and fits into the palm of your hand.
A pre-lubricated catheter doesn’t require you to lubricate the catheter with a lubricant packet, which decreases the chance of your hands or the lubricant packet accidentally touching the catheter and introducing germs.
If you have dexterity problems, CompactCath Lite, in particular, is easy to use for all dexterity levels—the packaging comes with a hoop that you can hook your finger through to easily open the package, and the entire catheter tube is encased in a plastic sleeve for easy insertion. When you self-catheterize, you might find it necessary to hold on to the catheter tube in order to guide it in, but with a catheter tube encased in a plastic sleeve, you can navigate the tube without actually touching it—simply pinch and push the plastic sleeve back as you insert.
Hopefully, the above tips can help you get a better handle on your diabetic bladder. Please note that these are not formal medical advice since everyone’s condition is different. Always consult your doctor on what’s right for you.
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