Bladder Innervation and Diabetic Cystopathy

Pathophysiology of Diabetic Cystopathy

• Diabetic cystopathy, which occurs in up to 80% of type 1 diabetic patients, is characterized by impaired detrusor contractions due to autonomic neuropathy affecting parasympathetic pathways 1
• Changes in bladder function can be observed as early as within 1 year from diagnosis in diabetic patients, with decreased acceleration of detrusor muscle contraction being an early sign of autonomic neuropathy 3

Clinical Evaluation and Monitoring

• Urodynamic studies in patients with bladder dysfunction show detrusor overactivity as the most common finding (48%), followed by impaired detrusor contractility (30%) 2
• The American Diabetes Association recommends yearly post-void residual (PVR) measurement and urine dipstick testing in all patients with insulin-dependent diabetes to monitor for bladder dysfunction 1