Structured Bladder Function Training Added to Usual Glycaemic Management for Preventing Urinary Tract Infection in Patients With Type 2 Diabetes Mellitus and Neurogenic Bladder: A Retrospective Study.

BACKGROUND: To evaluate the effects of adding structured bladder function training to usual glycaemic and urological management on urinary tract infection (UTI) in patients with type 2 diabetes mellitus (T2DM) and neurogenic bladder. METHODS: This retrospective cohort study included 97 patients treated between April 2022 and April 2025. According to documented management pathways, patients received either usual care (usual glycaemic and urological care) alone (n = 47) or usual care plus structured bladder function training (n = 50) and were followed for 6 months. Glycaemic indices [fasting plasma glucose (FPG), 2-hour plasma glucose (2h PG), glycated hemoglobin A1c (HbA1c)], post-void residual urine volume (PVR), urodynamic parameters (Qmax, Qave, voided volume), and recurrent symptomatic UTI were analysed. RESULTS: Both groups showed significant improvements in glycaemic indices over time. Because glycaemic management was similar between groups, glycaemic results were interpreted as reflecting routine diabetes care rather than the effect of bladder function training. PVR decreased significantly, with significant group, time, and interaction effects (all p < 0.001), and remained lower in the bladder function training group during follow-up. Urodynamic parameters improved in both groups, with greater improvements in the bladder function training group. The cumulative recurrent symptomatic UTI rate was significantly lower in the bladder function training group (8.00% vs. 25.53%, p = 0.008). CONCLUSIONS: In this retrospective cohort, adding structured bladder function training to usual glycaemic and urological management was associated with improved voiding function and reduced UTI in patients with T2DM and neurogenic bladder.