Sexual problems and bladder problems are common as people age, but diabetes can make these problems worse. You or your partner may have trouble having or enjoying sex. Or, you may leak urine or have trouble emptying your bladder normally.
See a health care professional for problems with sex or your bladder. These problems could be a sign that you need to manage your diabetes differently. You may find it embarrassing and difficult to talk about these things. However, remember that health care professionals are trained to speak with people about every kind of health problem. Everyone deserves to have healthy relationships and enjoy the activities they love.
Women with diabetes are more likely to have yeast infections, because yeast organisms can grow more easily when your blood glucose levels are higher. Yeast infections can be uncomfortable or painful and prevent you from enjoying activities, including having sex.
People with diabetes are more likely to have other types of UI, such as stress incontinence. Nerve damage, obesity, and bladder infections, which are linked with diabetes, are often related to bladder control problems. Leaking urine can cause you to avoid activities you once enjoyed, including sex.
People with diabetes are more likely to have urinary tract infections, also called bladder infections, or cystitis. See a doctor right away if you have frequent, urgent urination that may be painful. Bladder infections can develop into kidney infections and can make bladder symptoms, such as leaks and urine retention, worse. Also, bladder infections can get in the way of your everyday life, including intimacy. Managing your blood glucose levels can help prevent bladder infections.
As many as 1 in 3 Americans have some type of urinary incontinence that causes them to leak urine uncontrollably. Urinary incontinence, in general, more commonly affects women. But overflow incontinence tends to affect more men.
Your healthcare provider does a physical exam, which may include a pelvic exam or a rectal prostate exam, depending on your gender. Your healthcare provider may ask you to keep a bladder diary to track your fluid intake, bathroom use and urine leakage for two to three days.
Steps like bladder training and double voiding can prevent an overfull bladder from causing leaks. You can also do pelvic floor exercises daily. These exercises strengthen the muscles that support your bladder and urinary system.
Stress Urinary Incontinence (SUI) is when urine leaks out with sudden pressure on the bladder and urethra, causing the sphincter muscles to open briefly. With mild SUI, pressure may be from sudden forceful activities, like exercise, sneezing, laughing or coughing. If your SUI is more severe, you may also leak with less forceful activities like standing up, walking or bending over. Urinary "accidents" like this can range from a few drops of urine to enough to soak through your clothes.
Another common bladder problem is called Overactive Bladder (OAB), or Urgency Urinary Incontinence (UUI). People with OAB have an urgent, "gotta go" feeling that they can't control. Some people with OAB leak urine when they feel that urge. The difference between SUI and OAB is anatomical. SUI is a urethral problem while OAB is a bladder problem. With SUI, the urethra cannot stop the sudden increase in pressure. With OAB, the bladder spasms and squeezes uncontrollably. To learn more about OAB, visit our OAB web page.
The key symptom of SUI is when urine leaks out during any activity that increases abdominal pressure. The amount can be a few drops to tablespoons or more. If you have mild SUI, you will leak during forceful activities such as exercise. You may also leak when you sneeze, laugh, cough or lift something heavy. If your SUI is moderate or more severe, you may also leak when you do less strenuous activities, like standing up or bending over.
When you speak with someone who can address your concerns, it helps to write down what you want to ask in advance. Bring your list with you to your visit. You may also want to begin a bladder diary. The bladder diary is a tool to track urinary patterns. With it, you write down when you urinate and leak, what might trigger problems, and eating /drinking patterns for a few days. Bring the diary with you to your appointment. You and your healthcare provider will go over it together.
It is a good idea to start and keep a "bladder diary." This is a tool to track your day-to-day symptoms. In your diary, you will write down what fluids you drink and how often you go to the bathroom. You also need to note when you have leaks. Include what you were doing when the leak happened, such as running, coughing or sneezing.
There are two types of urinary pad tests: the one- hour test and the 24-hour test. The one-hour pad test is usually done in the office to learn about leakage with exercise or movement. The pad is removed and weighed afterwards to evaluate the amount of urine leaked. The 24-hour urine pad test is usually done at home for a complete day and night's evaluation.
There are currently no drugs approved in the U.S. to treat SUI. Sometimes if you have SUI and OAB (Mixed Incontinence), your health care provider may prescribe OAB drugs or OAB treatments. These drugs may help reduce leaks for an overactive bladder. They do not treat SUI.
People who are overweight or obese are more likely to develop SUI. Losing weight reduces the severity of SUI. Many people find that losing just 10 pounds can lead to fewer leaks. Your healthcare provider can help you set safe, realistic goals for weight loss.
A bladder diary is the starting point for bladder training. You record: (1) how much you drink; (2) when you urinate; and (3) when leaks occur. The diary allows you and your healthcare provider to see how often you urinate now and whether bladder training can help you. With bladder training, your healthcare provider may ask you to follow a fixed schedule to urinate. You may be asked to lengthen the time between bathroom visits by small amounts over time. It is important to try this only if your healthcare provider suggests it as some people have more urine leaks when they wait too long to go to the bathroom.
Quitting smoking is one of the most important things you can do for your health. A chronic cough from smoking may increase the frequency and severity of leaks. It may also cause added strain to the pelvic floor. When you quit smoking, coughing may decrease. This helps to reduce pressure on the pelvic floor muscles, which reduces leaks.
If your pelvic floor muscles are weak and you are female, an inserted vaginal device may prevent leaks. Examples are tampons, over-the-counter pessaries and custom fitted pessaries. These devices typically press against the wall of the vagina and the urethra. The pressure helps reposition and support the urethra. This leads to fewer leaks with minimal risk. There are different types of devices women can use which include:
Some women find that inserting a simple tampon during exercise prevents leaks. But tampons have not been approved for this purpose. There is no research that shows tampons can prevent urinary leakage.
Prescription pessaries are small, often made of medical grade silicone. These must be fitted just for you by a specialist. Like other pessaries, they are inserted into your vagina. Your pelvic floor muscles hold it in place. When fitted properly, you won't notice that it's there. You can go about your daily activities comfortably. Your healthcare provider can remove, check and replace them. Or they can teach you how to remove, clean and replace them yourself. Some women wear the pessary 24 hours a day, but most women wear them during the day and remove them at night. The pessary must be removed before having sexual intercourse. It's best not to wear them all the time, since they can irritate the urethra. This could lead to blood in the urine (hematuria) and urinary tract infections. Still, these devices are useful for reducing leaks during strenuous activities like running, lifting or playing tennis. Pessaries are generally safe, with a small risk of infection. If you use a pessary, set a schedule to visit with your healthcare provider. That way it can be checked, cleaned, and refitted on a regular basis or as needed.
A simple urethral plug can be inserted to create a barrier. They may be shaped like a thin flexible rod. Some have a balloon on the end that can be inflated and deflated to block leaks. When it's time to urinate, they can be deflated or pulled out.
It helps to learn as much as you can before you decide to move forward with surgery. Explain your goals to your healthcare provider. Find out which type of surgery is recommended and how much it may reduce urine leaks to see if it's worth doing. Learn what to expect during and after surgery. Also ask about risks and possible complications.
Often, the injections are done under local anesthesia in your healthcare provider's office. The injections can be repeated if needed. This method may not be as effective as other surgeries, but the recovery time is short. Bulking agents are a temporary treatment for SUI. Of every 10 women who have these injections, between 1 in 3 are cured of leaks, which can last for a year.
The artificial urinary sphincter cuff is filled with fluid which keeps the urethra closed and prevents leaks. When you press on the pump, the fluid in the cuff is transferred to the balloon reservoir. This opens your urethra and you can urinate. Once urination is complete, the balloon reservoir automatically refills the urethral cuff in 1-3 minutes.
Stay in touch with your healthcare provider/surgeon about follow-up care. Typically, you will be asked to visit your surgeon between six weeks and six months after surgery for a follow-up visit. Your bladder may also be tested to see how well its releasing urine and if urine remains in the bladder after going to the bathroom. If leaking symptoms remain or if you have any pain, let your surgeon know right away. 781b155fdc