Volume 29, Issue 164, October 2025

The impact of diabetic neuropathy on the function of the bladder and the urethral sphincter

Justyna Gręda^1♦, Bartosz Zieliński¹, Karol Mateusz Wojnarowski¹

¹St. Alexander Hospital in Kielce, Poland

^♦Corresponding author
Justyna Gręda, St. Alexander Hospital in Kielce, Poland

ABSTRACT

Introduction: Diabetic neuropathy, its autonomic forms, is a common complication of longstanding diabetes mellitus. It has profound impacts on lower urinary tract function, affecting both the bladder and the urethral sphincter, and frequently results in significant morbidity known as diabetic cystopathy or neurogenic bladder. Results: Patients with diabetic neuropathy commonly experience elevations in postvoid residual urine volumes, in addition to reductions in detrusor muscle contractility and decreased bladder sensation. For example, these alterations can lead to signs such as urinary retention. Other signs include recurrent urinary tract infections plus overflow incontinence. Urgency and frequency may present during the early stages, while a large atonic bladder, unable to empty effectively, reveals itself in later stages. The urethral sphincter acts for itself and comes across as dyssynergia. It also causes muscle weakness, leading to impaired coordination. These signs additionally aggravate micturition problems and incontinence. These dysfunctions are due to neuropathic changes that affect both sensory and motor innervation, as well as reduced nerve growth factor and autonomic dysregulation. Conclusions: Diabetic neuropathy significantly impairs both usual bladder function and urethral sphincter function, as detailed neurogenic processes contribute to lower urinary tract symptoms. Preventing urinary complications as well as preserving quality of life in diabetic patients requires managing by identifying early.

Keywords: diabetic neuropathy, bladder dysfunction, urethral sphincter, neurogenic bladder

Medical Science, 2025, 29, e200ms3691

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Published: 03 October 2025