Prof. Dr. Mariana Gonçalves de Oliveira Taranto is the newest faculty member of the Graduate Program in Pharmacology at UNICAMP. In her innovative project, already funded by FAPESP (grant no. 2024/20136-9), she will investigate underactive bladder in diabetes: a complication that is still poorly understood, yet has major impacts on patients’ lives.
The researcher’s proposal is to investigate the cellular and molecular processes that lead to dysfunction of bladder smooth muscle over the course of disease progression. By better understanding these mechanisms, the study may pave the way for the development of new therapeutic approaches in the future.
Prof. Mariana is currently recruiting new students to join the project. The FAPESP grant includes undergraduate research and master’s scholarships. In addition, she is also accepting PhD candidates, for whom she may apply for funding through research agencies. Interested individuals should contact marigo@unicamp.br by email
Building a career focused on urinary dysfunctions
Prof. Mariana holds a degree in Pharmacy from Faculdade de Americana, a Master’s degree in Molecular and Functional Biology with an emphasis on Human Physiology from the Institute of Biology at UNICAMP, and a PhD in Pharmacology from the School of Medical Sciences (FCM) at UNICAMP.
She completed her postdoctoral training at the Department of Pharmacology at FCM/UNICAMP, including a research period abroad at the Department of Medicine at Beth Israel Deaconess Medical Center (Harvard Medical School), as well as at the Department of Internal Medicine at the School of Medicine of the University of São Paulo (USP).
She also served as an assistant professor in the Graduate Program in Health Sciences at Universidade São Francisco (USF). She has been a faculty member in the Department of Pharmacology at UNICAMP since early 2026.
Prof. Mariana has been studying the urinary bladder since 2013, when she began her PhD in the Graduate Program in Pharmacology. At that time, her main project focused on an experimental treatment for interstitial cystitis, another condition affecting the bladder. Although this was her primary focus, she was already conducting parallel research using models of bladder dysfunction in diabetes.
She highlights the importance of research in benign urology: “Research in this area receives far less attention than other fields of medicine. Although we deal with benign dysfunctions that affect millions of people and have a major impact on quality of life, they are not seen as severe or life-threatening diseases. As a result, they receive less funding and are less explored scientifically.”
The focus of her work is the bladder smooth muscle. She explains: “Ultimately, most urinary symptoms come down to a problem with smooth muscle contraction. In general, when we observe lower urinary tract symptoms, there are a few likely scenarios. The bladder may contract too much, characterizing overactive bladder; it may contract too little, in the case of underactive bladder; or there may be a restriction to urinary flow, such as when the urethra or prostate contracts excessively and obstructs urine passage.
“In all these scenarios, we are dealing with smooth muscle, whether in the bladder, urethra, or prostate. This places smooth muscle at the center of urinary function regulation. That is why I decided to focus my research on better understanding this tissue.”, Prof. Mariana adds.
Bladder dysfunction in diabetes: a common but overlooked complication
Among the conditions that have drawn the researcher’s attention is bladder dysfunction associated with diabetes mellitus. Although it is considered a relatively common complication, it receives far less attention than other consequences of diabetes, such as cardiovascular, renal, or ocular diseases.
It is estimated that a significant proportion of diabetic patients develop some degree of urinary alteration over the course of the disease. These may include increased urinary frequency, urgency, or difficulty emptying the bladder completely. Studies indicate that more than 50% of individuals with diabetes mellitus may experience some type of urinary symptom.
These symptoms often develop gradually and may go unnoticed. In many cases, patients believe these changes are part of aging or lifestyle habits, rather than a metabolic complication. In general, urinary symptoms and incontinence are still considered taboo topics, which hinders diagnosis and treatment and significantly impacts quality of life. Many people, both men and women, avoid discussing urine leakage due to embarrassment.
There is also a widespread misconception that incontinence is an inevitable consequence of aging, leading to resignation and lack of treatment. This stigma can lead to depression, social isolation, and impairment in sexual life. Moreover, managing diabetes itself is already a continuous and demanding process that often generates emotional and physical stress, adding further burden to patients.
Although intensive glycemic control significantly reduces the risk of complications, it is often insufficient to prevent or reverse certain types of damage. Once the disease reaches a decompensated (underactive) stage, it is typically irreversible.
From a scientific perspective, understanding this condition is not straightforward. The control of urination depends on a highly integrated system involving the brain, peripheral nerves, bladder musculature, and other structures of the lower urinary tract. Diabetes can affect multiple components simultaneously. Chronic metabolic alterations, inflammatory processes, and peripheral nerve damage may alter both bladder sensitivity and contractility, profoundly affecting its structure and function.
Although the pathogenesis of bladder dysfunction is likely multifactorial, it is essential to identify the key determinants and how they contribute to disease development. Early theories suggested neuropathy as the main cause; however, more recent evidence strongly points to smooth muscle dysfunction, which has important therapeutic implications.
Underactive bladder: a silent complication of diabetes
In her new project, Prof. Mariana will investigate underactive bladder, a condition that remains poorly understood. It is often referred to as a “lazy bladder,” as patients experience difficulty urinating, weak urinary stream, and incomplete bladder emptying. In some cases, there is also a loss of bladder sensation, which may cause individuals to urinate without fully realizing it.
In diabetes, underactive bladder may develop over time. Prof. Mariana explains: “In individuals with diabetes, especially in the early stages of the disease, it is common to observe the development of overactive bladder syndrome.” This occurs partly due to increased urine production. She continues: “Over time, however, we observe a progressive loss of bladder function, which characterizes underactive bladder. We still do not know whether this represents an inevitable progression, meaning that every patient with overactive bladder will eventually develop underactive bladder. So far, this is one of the most widely accepted hypotheses.”
She compares this condition to heart failure: “When an individual develops hypertension, the heart initially responds with hypertrophy to compensate for the increased workload. Over time, however, this chronic effort can lead to loss of function, progressing to heart failure and, in severe cases, cardiac failure.”
“The urinary bladder shares similarities with the heart in this regard. Both are hollow organs that must continuously handle significant workloads. However, while knowledge about heart failure has advanced greatly in recent decades, underactive bladder remains poorly understood.”, she adds.
Unlike overactive bladder in early diabetes, underactive bladder occurs less frequently. However, it has major clinical relevance, particularly because treatment options are limited. Prof. Mariana explains: “It is not possible to predict when underactive bladder will develop. In diabetic individuals, we observe different patterns of urinary dysfunction, and it may take many years before this condition appears.”
“In practice, the main therapeutic option is intermittent catheterization. Patients must manually empty their bladder using a catheter and a collection bag. There are no effective pharmacological treatments available, which reflects how little this condition is understood.”, Prof. Mariana adds.
Training new researchers and advancing scientific frontiers
At the end of the interview, Prof. Mariana reflects on her experiences and the role of a mentor: “After becoming a professor, I had a clear realization that my role is to train students. To help them become good professionals. It is very rewarding to see people grow and to be able to contribute to that development. It gives a strong sense of purpose and motivation to continue.”
As she begins this new stage at UNICAMP, Prof. Mariana aims to expand the frontiers of knowledge on underactive bladder in diabetes, an area that remains underexplored but has a significant impact on patients’ quality of life. Her project brings together cutting-edge molecular research, clinical relevance, and the training of new scientists. Understanding the mechanisms of the disease points toward a future in which new therapeutic strategies may become a reality rather than a distant possibility.
To learn more:
Diabetic bladder (paper #1) (DOI: 10.3390/antiox13101155)
Diabetic bladder (paper #2) (DOI: 10.3390/biomedicines12050939)
Diabetic bladder (paper #3) (DOI: 10.3390/metabo13060710)
Written by:
Mia Schezaro Ramos
Pharmacist. Ph.D. in Pharmacology. Science journalist, illustrator, trans, Nintendo enthusiast, K-pop fan, and dependent on physical exercise to stay sane.