The knowledge of the diabetic cystopathy in relation to the prevalence and cost of the health care system are still unclear. Every second patient with diabetes mellitus develops signs of diabetic urinary bladder symptoms. Both the symptoms of over- and hypo-activity are possibly based on pathological changes which are based on different levels: they influence the smooth muscle of the detrusor in situations of oxidative stress, cholinergic, purineric innervations through the receptors of the endothelium, muscarinic sub-receptors, NOS as a mediator, sodium pump, prostaglandine, nerve growth factor (NGF), and other factors. There are very few therapeutic approaches that target the treatment of diabetic cystopathy. Whereas with experimental, as with all other diabetic side effects, optimum blood sugar adjustment has the best possibility to influence to prognosis. However, only experimental genetic approaches using NGF substitution are published.
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