3.2.5.0 Genitouri­nary Dis­tur­bances.

Di­a­bet­ic au­to­nom­ic neu­ropa­thy may also cause genitouri­nary dis­tur­bances, in­clud­ing sex­u­al dysfunc­tion and blad­der dysfunc­tion. In men, di­a­bet­ic au­to­nom­ic neu­ropa­thy may cause erec­tile dysfunc­tion and/‍or ret­ro­grade ejac­u­la­tion (107). Fe­male sex­u­al dysfunc­tion oc­curs more fre­quent­ly in those with di­a­betes and pre­sents as de­creased sex­u­al de­sire, in­creased pain dur­ing in­ter­course, de­creased sex­u­al arousal, and in­ad­e­quate lu­bri­ca­tion (111). Lower uri­nary tract symp­toms man­i­fest as uri­nary in­con­ti­nence and blad­der dysfunc­tion (noc­turia, fre­quent uri­na­tion, uri­na­tion ur­gen­cy, and weak uri­nary stream). Eval­u­a­tion of blad­der func­tion should be per­formed for in­di­vid­u­als with di­a­betes who have recur­rent uri­nary tract in­fec­tions, pyelonephri­tis, in­con­ti­nence, or a pal­pa­ble blad­der.