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Urology/urinary frequency caused by diabetes


Dear Dr leslie. My name is Elbert vaughn. I am a type 2 diabetic. I have many diabetic complications. On of the complications I have is urinary frequency. It is not caused by elevated sugar in the blood. My sugars are well managed(my a1c has been normal since I have been diagnosed with diabetes. I have been diabetic for only 4 years). It is caused by bladder neuropathy. I don't know if you have expertise on this condition, but I decided to ask for your opinion(maybe I need to pose question to a neurlogist). I have tried many medicines that deal with overactive bladder(detrol la, vesicare etc). Also others medications that work similarly(by relaxing the bladder). I have the urge to urinate every 15 to 20 minutes. I cannot sleep. I am voiding normally, and I am able to empty my bladder completely(I have to jab my bladder to completely empty my bladder(it is called the cred'e method). So my bladder nerves are effected by my diabetes in some way. I have done research, and I have come to learn that their is a feedback system from the bladder to the brain. They communicate. In diabetics since the bladder nerves are damaged they are irratated once bladder begans to fill up with urine. Normally your brain gets the message to urinate after the volume of urine reaches a certain level in bladder(I think every 4 hours or more), but since my bladder nerves are most likely damaged from diabetes. The nervs are misfiring. I am losing my mind because I cannot sleep. If you can give me any advice. Any medicine that you can think of that can possibly help me, please, please give me some advice on what to do. I have talked to my doctor. He has no other options to give me other than the ones I have just mentioned(vesicare etc). Any advice you can give me on this matter. I really would appreciate your opinion/advice. Thank you. Elbert Vaughn


Well, we know that you have urinary frequency but we don't know about the volume or the post void residual.  Diabetics typically get a bladder condition called sensory paralytic bladder where patients lose the ability to know when the bladder is full.  They also tend to make more urine than normal  This combination can lead to bladder muscle damage as well.  We also know that the typical bladder relaxing meds haven't worked which suggests that your problem is not bladder overactivity but something else.

First, you need to do a 24 hour voiding diary and write down the exat amount in ML you void and the time for exactly 24 hours.  If you could do this for 2 separate days it would be very helpful.

Next, you should consult a urologist.  We have the instruments to quickly determine if the bladder is emptying well or not and the 24 hour voiding diary will help determine if there is a urinary volume issue or not.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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