poor control of sphincter muscles around the tube (urethra) that carries urine from the bladder to outside the body,
urine retention-the inability to properly empty the bladder, and
urinary tract infections.
Symptoms of overactive bladder include frequent urination-more than eight times per day or two times per night-the sudden strong need to urinate, and leakage of urine following the urge to urinate. If nerves controlling the sphincter muscles around the urethra are damaged, this can cause urine leakage if the muscles are loose, or inability to release urine if the muscles are too tight (contracted). Nerve damage may prevent the bladder from emptying completely, causing urine to back up, and increasing pressure on the kidneys, leading to kidney damage.
Urinary tract infections can occur when urine remains in the body too long, and are caused when bacteria, most commonly from the digestive tract, reach the urinary tract. These infections occur in the urethra, the bladder, or the kidney, and symptoms include a frequent urge to urinate, pain or burning during urination, cloudy or reddish urine, pressure above the pubic bone in women, and a feeling of fullness in the rectum in men. Nausea, fever, and back or side pain are signals that the infection may have reached the kidneys.
Your doctor may use a variety of tests to check bladder function, including x-rays, urodynamic testing, cystoscopy-a scope to look inside the bladder-and for urinary tract infections, testing urine for bacteria. If you have bladder issues, tell your doctor right away. Prompt diagnosis and early treatment are important for preventing further damage and worsening of symptoms. And the treatment may be easier than you realize. Emptying the bladder on a schedule, medications, exercises to strengthen pelvic muscles (Kegels), and surgery all may be used to manage diabetes-related urologic problems.
(Sexual and Urologic Problems of Diabetes. U.S. Department of Health and Human Services. National Diabetes Information Clearinghouse.)