An overactive bladder — underestimated trouble of diabetic patients

Abstract

An overactive bladder (OAB) is a prevalent syndrom in general population with uncertain multifactorial aetiology. The features of OAB are also present in significant percent of diabetics. The clinical picture of OAB consists of troublesome clinical symptoms (urgency, frequency, nocturia, urge urinary incontinence). The precise medical history is the base of proper OAB diagnosis and the exclusion of all known reasons for OAB (anatomical, functional and hormonal) is essential to confirm its idiopathic aetiology. The background of OAB is formed by the disturbances of both structure and function of urothelium besides urinary bladder innervation and muscular dysfunction. In diabetics, the hyperglycaemia and secondary polyuria as well as the late diabetic complications (microangiopathy and neuropathy) are responsible for the OAB development. The mode of OAB treatment in diabetics does not differ from these accepted for general population, although the role of optimal hypoglycaemic therapy is emphasied. Unfortunately, even long-term multidirectional therapy (non-pharmacological, pharmacological or invasive treatments) does not ensure successful cure and all its effects are limited to mitigation of clinical signs intensity.