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Retrospective clinic and urodynamic study in the neurogenic bladder dysfunction caused by human T cell lymphotrophic virus type 1 associated myelopathy/tropical spastic paraparesis (HAM/TSP)
Author(s) -
Troisgros Odile,
Barnay JoseLuis,
DarbonNaghibzadeh Farideh,
Olive Pascale,
RenéCorail Patrick
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22952
Subject(s) - tropical spastic paraparesis , medicine , myelopathy , retrospective cohort study , surgery , urology , spinal cord , psychiatry
HTLV‐I associated tropical spastic paraparesis (TSP) and HTLV‐I associated myelopathy (HAM) is an endemic disease in Caribbean Island. Bladder‐sphincter dysfunctions are almost present. The objectives of the study are to describe clinic and urodynamic characteristics of voiding disorders in Martiniquan population, evaluate if there is a relationship between motor and urinary handicap, and evaluate prognosis factors of urologic complications. Methods Retrospective study of 60 patients suffering from HAM/TSP. Clinical, urodynamic datas, scale of urinary and motor handicap (Urinary Symptom Profile [USP] questionnaire and Osame Score) were collected. Results Storage symptoms were the most frequent (75%) whatever type of detrusor activity. Detrusor overactivity was the most frequent disorder (68.3%). Bladder compliance was normal in half percent of the cases. Urethral activity was increased in 47% of the cases. Detrusor sphincter dysynergia was found in 78% of the cases, post‐void residual in 58% of cases. Sixty five percent of the patients present at least one urologic complication (morphologic and/or infectious) but there was no correlation with motor enablement ( P = 0.3097), neither urodynamic study ( P = 0.432 for detrusor overactivity, P = 0.107 for detrusor underactivity, P = 0.058 for high urethral activity, P = 0.893 for detrusor sphincter dysynergia, P = 0.850 for post‐void residual volume), neither with evolution duration of HAM/TSP ( P = 0.348). USP score was not in correlation with Osame score ( P = 0.07). Conclusion Urologic symptoms are not always in relationship with urodynamic study: a systematic urodynamic study is necessary to evaluate HAM/TSP neurogenic bladder. No clinic or urodynamic criterias are predictive of urologic complications. These patients need a close follow up. Neurourol. Urodynam. 36:449–452, 2017 . © 2016 Wiley Periodicals, Inc.