Title:Genitourinary Complications of Diabetes Mellitus: An Overview of Pathogenesis, Evaluation, and Management
Volume: 13
Issue: 5
Author(s): Jason Gandhi, Gautam Dagur, Kelly Warren, Noel L. Smith and Sardar A. Khan*
Affiliation:
- Department of Urology, Stony Brook University School of Medicine, Health Sciences Center T9- 040, 101 Nicolls Road, Stony Brook, NY 11794,United States
Keywords:
Chronic kidney disease, diabetes mellitus, diabetic angiopathies, diabetic cystopathy, diabetic nephropathies, diabetic
neuropathies, genital mycotic infections, lower urinary tract symptoms, urinary tract infections.
Abstract: Background: Diabetes mellitus is a vastly prevalent metabolic disorder with escalating
global health concerns. Particularly when mismanaged, chronic micro- and macrovascular complications
may highly impair physiological systems while immunodeficiency disposes us to infection.
Objective: We investigate infections, localized complications, and neoplasms of the genitourinary system
secondary to the chronic complications of diabetes mellitus in males and females.
Method: A comprehensive MEDLINE® search was guided using key words relevant to diabetes mellitus
and the genitourinary system.
Results: Pathogen-friendly environments may implicate the sequelae of urinary tract and genital mycotic
infections, potentially generating necrosis, abscess, and other inflammatory complications, which
may present concomitantly with neurogenic and/or vasculogenic dysfunction to further exacerbate an
existing genitourinary condition. Manifestations of the adrenal, renal, and genital organs and tissues
are discussed as they relate to vascular, immunodeficient, and other hyperglycemic complications of
the diabetic state. Among those, chronic kidney disease and cystopathy are the most prevailing and
detrimental. Though studies have connected diabetes to either an increased risk of developing or poor
prognosis of bladder, renal, prostate, endometrial, and cervical cancers, the explicit biological relationships
are as of yet inconclusive.
Conclusion: Despite the availability of precise treatments to ameliorate most presently reviewed conditions,
particularly urinary tract and genital mycotic infection-related sequelae, reversing permanent
vascular damage remains a great challenge. Leading a healthier lifestyle and managing diabetes mellitus
with a patient-centric approach from the outset are the most putative methods for preventing critical
long-term genitourinary manifestations of diabetes mellitus.
