[Functional disorders of the lower urinary tract in diabetes mellitus]

Type 2 diabetes mellitus is a well-known metabolic disease with increasing prevalence. Diabetic-related complications lead to different types of organ damage, some of which some of which are less well-known. In the lower urinary tract, a complex interplay of neuronal, myogenic, and urothelial dysfunction leads to functional disorders of the lower urinary tract, with disorders of bladder storage and bladder emptying being in the forefront. In Germany, the number of patients with diabetes mellitus is estimated at over 8 million, with up to 2 million undiagnosed cases. Exact figures on diabetes-related dysfunction of the lower urinary tract are not available, partly because the early phase is often asymptomatic. Symptomatic patients often initially report symptoms of urgency, but later reduced sensitivity and ultimately a feeling of residual urine and urinary retention. Treatment options are limited, not always evidence-based, and often only evaluated in patients without diabetes. Behavioral therapy measures, drug therapy, peripheral neuromodulation, and catheter use such as single-use catheterization or permanent catheter diversion are used. In order to ensure optimal diagnosis and therapy, an understanding of the underlying pathologies and functional diagnostics is necessary.