Bladder dysfunction in human T cell lymphotropic virus infection: A prospective cohort study

Abstract

Background While bladder dysfunction is observed in the majority of patients with human T cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy (HAM), it is also observed in patients who do not fulfill all diagnostic criteria for HAM. These patients are classified as having possible or probable HAM/TSP. However, it remains unclear whether the severity and progression of bladder dysfunction occurs similarly between these two groups. Objective Compare the severity and evolution of bladder dysfunction in HTLV-1-infected patients with possible and definite HAM/TSP. Methods The present prospective cohort study followed 90 HTLV-1 patients with possible HAM/TSP and 84 with definite HAM/TSP between April 2011 and February 2019. Bladder dysfunction was evaluated by bladder diary, overactive bladder symptoms scores (OABSS) and urodynamic studies. Bladder dysfunction progression was defined as the need for clean self-intermittent catheterization (CIC). Results At baseline, nocturia, urgency and OABSS scores were worse in definite compared to possible HAM/TSP patients. The main urodynamic finding was detrusor overactivity, present in 77.8% of the patients with definite HAM/TSP versus 58.7% of those with possible HAM/TSP (P = 0.05). Upon study conclusion, the cumulative frequency of patients requiring CIC increased in both groups, from 2 to 6 in possible HAM/TSP and from 28 to 44 in definite HAM/TSP patients. The estimated time to need for CIC was 6.7 years (95%CI 6.5–7.0) in the possible HAM/TSP group compared to 5.5 years (95%CI 4.8–6.1) in the definite HAM/TSP group. Conclusions Although both groups showed similarities in bladder dysfunction and tended to progress to requiring CIC over time, patients with possible HAM/TSP presented less severe manifestations at baseline and progressed more slowly than those with definite HAM/TSP.

The Onset or Worsening of Lower Urinary Tract Symptoms in Patients Infected with COVID-19

“…Despite results consistent with ours, one major issue in their study is the potential for recall bias, as they did not assess patients during hospitalization but rather 10 -14 weeks post-discharge, asking about pre-COVID symptoms at that time. In addition to COVID-19 infection, new onset or recent worsening of urinary frequency, nocturia, urgency, and urgency incontinence have also been reported in other infectious diseases, such as human immunodeficiency virus (HIV) ( 18) and human T cell lymphotropic virus-1 (HTLV-1) infection (19). Similar to Daryanto et al (20), our research found that the most common LUTS in COVID-19-infected patients are those associated with OAB.…”

“…A frequency volume chart (FVC) was used to record urine leakage due to urgency or increased intra-abdominal pressure, as well as the frequency of urination for all patients over two consecutive days, aligning with the questionnaire scores. The study outcomes included the frequency of LUTS, quality of life score, the relationship between LUTS and quality of life in COVID- 19…”

“…Coronavirus disease 2019 (COVID- 19), first detected in China, has spread globally, resulting in the ongoing coronavirus pandemic and causing millions of human deaths (1,2). Coronavirus disease 2019 manifestations are highly diverse.…”

Заболевания, Ассоциированные С Т-Лимфотропным Вирусом Типа 1 Человека (HTLV-1)

“…Дисфункция мочеиспускания была более выражена у пациентов с нарушенной походкой [45]. Дисфункцию мочевого пузыря регистрировали даже у пациентов, которые не соответствовали диагностическим критериям НАМ/TSP [46]. Катетеризация мочевых путей и лекарственный препарат мирабегрон были эффективными средствами для облегчения симптоматики нарушения функции мочеиспускания [45].…”