title: A comprehensive review of urologic complications in patients with diabetes.
abstract: Diabetes Mellitus (DM) is a chronic disease characterized by hyperglycemia, as a result of abnormal insulin production, insulin function, or both. DM is associated with systemic complications, such as infections, neuropathy and angiopathy, which involve the genitourinary tract. The three most significant urologic complications include: bladder cystopathy, sexual dysfunction and urinary tract infections. Almost half of the patients with DM have bladder dysfunction or cystopathy, which can be manifested in women as hypersensitivity (in 39-61% of the diabetic women) or neurogenic bladder. In males it can be experienced as lower urinary tract symptoms (in 25% of diabetic males with a nearly twofold increased risk when seen by age groups). Additionally, an increased prostate volume affects their micturition as well as their urinary tract. Involving sexual dysfunction in women, it includes reduced libido, decreased arousal, clitoral erectile dysfunction and painful or non-sensitive intercourse; and in diabetic males it varies from low libido, ejaculatory abnormalities and erectile dysfunction. Globally, sexual disorders have a prevalence of 18-42%. Erectile dysfunction is ranked as the third most important complication of DM. Urinary tract infections are observed frequently in diabetic patients, and vary from emphysematous infections, Fournier gangrene, staghorn infected lithiasis to repetitive bacterial cystitis. The most frequent finding in diabetic women has been lower urinary tract infections. Because of the high incidence of obesity worldwide and its association with diabetes, it is very important to keep in mind the urologic complication associated with DM in patients, in order to better diagnose and treat this population.
authors.affiliation: Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, 21 sur 1103, Barrio de Santiago, Puebla, Puebla C.P 72410 México.
authors.forename: Fernando
authors.initials: F
authors.lastname: Arrellano-Valdez
authors.affiliation: Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, 21 sur 1103, Barrio de Santiago, Puebla, Puebla C.P 72410 México.
authors.forename: Marta
authors.initials: M
authors.lastname: Urrutia-Osorio
authors.affiliation: Hospital Ángeles de Puebla, Puebla, México ; Hospital Universitario de Puebla, Benemérita Universidad Autónoma de Puebla, Avenida 25 Poniente 1301, Los Volcanes, 72410 Heroica Puebla De Zaragoza, PUE Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: Arroyo
authors.affiliation: Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, 21 sur 1103, Barrio de Santiago, Puebla, Puebla C.P 72410 México.
authors.forename: Elena
authors.initials: E
authors.lastname: Soto-Vega
keywords: Diabetes mellitus; Urologic diseases