Male patients with diabetes may have specific health problems especially as they get older. Urological complications, and erectile dysfunction are two common issues men with diabetes may experience. Discover more about these problems and how to minimize the risk of early onset.
Sexual Problems and Diabetes
People with diabetes can experience damage to the nerves and small blood vessels in the body especially those with poor blood sugar control. Autonomic nerves control the internal organs which includes the body’s involuntary response to sexual stimuli. If these nerves are damaged it can disrupt normal sexual function. This problem can worsen when damaged blood vessels reduce the blood flow to the sexual organs.
Men with erectile dysfunction (ED) are unable to sustain a firm erection to engage in sexual relations. Some are totally unable to achieve an erection. Men with diabetes are up to three times more likely to have ED than men who do not have the condition. Men with diabetes can experience erection problems up to 15 years earlier than men who do not have diabetes. Kidney disease, high blood pressure, neuropathy, and blood vessel disease are all complications that are associated with diabetes and ED. Other reasons why Erectile Dysfunction may occur include smoking, alcohol abuse, hormonal irregularities, psychological issues, and medications.
Diagnosing and Treating ED
Men experiencing any of the symptoms of Erectile Dysfunction should feel comfortable discussing them with a doctor. The physician may ask about the medical history, smoking and drinking problems and current health issues. A physical exam will be done along with hormone blood levels. Blood glucose levels will be tested and need to be in control to help preserve physical function. A home test will be done to find out if the man gets erections during his sleep. The doctor will also discuss any recent problems that may have lead to ED such as stress, anxiety or depression. Talking to a therapist or a counselor may be helpful with psychological problems. The treatments for Erectile Dysfunction can include a vacuum erection device, oral medication, shots given in the penis, pellets in the urethra, and surgery.
What is Retrograde Ejaculation?
Poor blood sugar control and nerve damage may lead to retrograde ejaculation. It can also be caused by prostate surgery and certain medications. With this condition, some or all of a man’s semen enters the bladder rather than exiting the tip of the penis when he ejaculates. The internal muscles, known as sphincters, control this function and do not work as they should. As a result, the semen mixes with urine in the bladder and is released through urination. While it is not harmful to the bladder, it can lead to fertility problems.
Diagnosis and Treatment of Retrograde Ejaculation
To diagnose retrograde ejaculation, a urine sample is taken and analyzed to determine if it contains semen. If the condition is caused by diabetes or surgery, medication may be prescribed to help strengthen the sphincter muscles. For those looking to have children, an urologist may try techniques such as collecting sperm from the man’s urine. This sperm can be used for artificial insemination.
Urologic and Bladder Problems with Diabetes
Men with diabetes may also experience urologic problems including urinary tract infections and bladder issues. Over half the men with diabetes experience bladder problems due to nerve damage from out of control blood sugars for long periods of time. This makes it more difficult to control bladder function. There are a few common bladder problems associated with diabetes and nerve damage.
Urine retention occurs when the nerves do not convey the message to the bladder that it is time to urinate. Many times the muscles are too weak to totally empty the bladder. Urine retention can lead to an infection in the bladder or kidneys. Kidney damage can be the result when the bladder becomes too full. Overflow incontinence and leakage may also occur.
With an overactive bladder nerve damage sends continued signals to the bladder. Many of these signals are inaccurate and occur when the bladder is not full. This means a person may urinate twelve or more times throughout the day and night. It also makes people feel like they must urinate right away and can lead to leakage and incontinence. There are new oral medications for this condition along with bladder muscle retraining.
Diagnosing and Treating Bladder Problems
Several tests may be conducted to diagnose bladder problems including x-rays, a cystoscopy to view the inside of the bladder, and urodynamic testing to check the bladder function. Treatments may include timed urination on a schedule, the use of a catheter to drain the urine, and massaging the lower abdomen when it is time to urinate. Certain exercises can strengthen muscles around the bladder as well as medications. In some cases, surgery may be necessary.
Urinary Tract Infections (UTIs)
If bacteria starts to grow in the urethra, it can travel through the urinary tract and lead to an infection. If this goes untreated the bladder can become infected which is called cystitis. A lack of treatment may send the infection go to the kidneys causing an infection called pyelonephritis. Symptoms of a UTI include burning during urination, a frequent urge to urinate, reddish or cloudy urine, and feeling full in the rectum. When it goes to the kidneys it can lead to a fever, nausea, and pain in the side or back. A doctor will request a urine sample to check for pus and blood. If the infection seems to have traveled other tests may be performed such as an ultrasound, pyelogram, or cystoscopy. In many instances, antibiotics are recommended for UTIs and kidney infections. It is also important to drink fluids to prevent future infections. Cranberry tablets or diet cranberry juice may help prevent infections in the future by making the bacteria slip off the bladder interior.
Men with diabetes need to have good blood glucose control and maintain a healthy weight to help prevent erectile dysfunction and other urological issues. Preventative measures should include no smoking, moderation in alcohol and doing daily exercise along with a healthful eating plan; these measures can help men with diabetes reduce the risk of problems such as ED, bladder control issues, and UTIs.
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