[Diagnosis and therapy of functional disorders of the bladder in persons with diabetes mellitus. What do we actually know?].

Although diabetes mellitus is one of the most common diseases worldwide, only few studies evaluating diagnosis and treatment of lower urinary tract complications of this disorder exist. In addition to diabetic (impaired sensation, reduced detrusor muscle contractility, elevated residual urine), 30-50% of patients can develop an overactive bladder. Basic diagnostics should include patient history, bladder diary, post-void residual and urinalysis. Advanced diagnostics include uroflowmetry, symptom scores and urodynamics. The evidence for all treatment options in patients with diabetes mellitus is low. Residual urine may be treated with coping strategies, Metoclopramid, alpha blockers and intermittent catheterization, but there is no evidence for parasympathomimetic medication. Overactive bladders can be treated by behavioral therapy, biofeedback, electrostimulation or antimuscarinics. In addition to cooperation with colleagues from other specialties, intensive urologic research is required for the development of evidence-based strategies for long-term urologic care of patients with diabetes mellitus.