Dustin: (Pointing to the genitals on the anatomical diagram) Does anything happen there during diabetes?

Grandma: That's it, Dustin. I'm going outside. You may explain this subject to my grandson in private, Dr. Ponds, but I don't need to hear about it in front of him.

Dr. Ponds: That's fine, Josephine.

(Exit Grandma)

Yes, Dustin, the genitals also experience complications in Type II diabetes. Typical complications involving the genitals include both urinary and sexual dysfunction.

Dustin: What is urinary dysfunction?

Dr. Ponds: Urinary dysfunction is the inability to manipulate the timing of and completeness of evacuation, or emptying, of the bladder. The patient cannot control when or how much they urinate. Inability to hold urine has the potential to cause embarrassment for the patient, and failure of the bladder to empty completely results in greater risk of bacterial infection of the urinary tract.

Dustin: What causes urinary dysfunction?

Dr. Ponds: Urinary dysfunction is mostly caused by neuropathy in the nerves that sense bladder fullness and induce contraction of the muscular bladder walls.

Dustin: What about the other dysfunction? What is that?

Dr. Ponds: Sexual dysfunction involves impotence and inability to achieve orgasm. Impotence is the consistent inability to sustain an erection. Impotence in males can vary from the complete inability of the penis to become erect to maintaining only very brief erections.

Dustin: Does neuropathy cause that type of dysfunction?

Dr. Ponds: Yes, partly. Impotence in diabetics is primarily caused by atherosclerosis. The sponge-like vascular tissues in the penis that cause erection are unable to fill with blood when arteries are partially blocked. Damage to the sensory and the motor nerves necessary for initiating and maintaining an erection compounds the effects of vascular failure. Inability to achieve orgasm in males and females originates from neuropathy and loss of erection. These physical complications can lead to psychological problems for the patient.

Dustin: Thank you, Dr. Ponds. I think you've cleared up these complications for me.

Dr. Ponds: You are certainly welcome, Dustin. (To the door) Josephine, I think you can come in now.

(Enter Grandma)

Grandma: It's about time. Let's move on to something else.

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