Genitourinary Complications of Diabetes Mellitus: An Overview of Pathogenesis, Evaluation, and Management

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.

Keywords: Chronic kidney disease; diabetes mellitus; diabetic neuropathies; diabetic angiopathies; diabetic cystopathy; diabetic nephropathies; genital mycotic infections; lower urinary tract symptoms; urinary tract infections.