Diabetic cystopathy

Diabetic cystopathy refers to the spectrum of voiding dysfunction in patients with diabetes mellitus. Diabetic cystopathy is marked by insidious onset and progression with minimal symptomology. The most common urodynamic findings are impairment of bladder sensation, increased post-void residual volume, decreased detrusor contractility that may progress to detrusor areflexia and diminished urinary flow. Treatment of diabetic cystopathy may be complicated by frequently occurring coexisting urologic conditions. The most common of these is bladder outlet obstruction. Therefore, treatment of diabetic cystopathy should be tailored to the symptom complex and clinical condition of the patient. Asymptomatic patients with manifestations of diabetic cystopathy may be treated with timed voiding. In contrast, the sine qua non for therapy in symptomatic patients is clean intermittent catheterization. While other modalities such as pharmacologic and surgical intervention have been described, none have been consistently effective.