Urodynamically proven lower urinary tract dysfunction in children after COVID‐19: A case series

Abstract

Case Since the declaration of COVID‐19 as a pandemic, other unexpected symptoms related to the infection besides the respiratory system have been reported. Although a few case reports have revealed that adult patients with COVID‐19 also complained of urinary frequency and nocturia, the exact pathophysiology is still unclear. In this case series, we present three children aged 14 to 17 years with urodynamically proven lower urinary tract dysfunction (LUTD) following COVID‐19. Outcome None of the patients had constipation or bowel disorder before the diagnosis of COVID‐19. In addition, neurological examination and related imaging revealed no signs of etiological factors. The median time from diagnosis of COVID‐19 infection to the onset of lower urinary tract symptoms was 3 months. Incomplete bladder emptying/urinary retention supported by increased bladder compliance, high post‐micturition residual urine volumes, and absence of detrusor pressure increase during the voiding phase in the pressure flow study (acontractile detrusor in two patients and hypocontractile detrusor in one patient) were observed. Conclusion We observed that LUTD (eg, incomplete bladder emptying, urinary retention) can be prominent some time after the diagnosis of COVID‐19. Even though psychogenic or neurogenic causes may not be excluded completely, clinicians should be aware of a recent COVID‐19 infection in children with sudden‐onset LUTD.

Evaluation of Overactive Bladder Symptoms in Patients Recovering from Post-Acute COVID-19 Syndrome

“…The exaggerated release of pro-inflammatory molecules also identified as “cytokine storm” can stimulate inflammation and demyelination of the pudendal nerve triggering bladder and bowel incontinence. 14 In contrast, it has been reported that an identical structural disorder can also lead to urinary and fecal retention through not entirely understood mechanisms. 15 …”

COVID-19 associated lower urinary tract symptoms in children

“…This paper involves three children aged 14-17 years who presented with urinary retention and required clean intermittent catheterization after a median interval of three months. The authors performed urodynamics and showed a-contractile detrusor in two patients and hypo-contractile detrusor in one patient)[ 5 ]. Our study did not involve invasive urodynamics but had some discordant findings.…”

“…One systematic review suggested dysregulation of renin-angiotensin system, the inflammatory process in the prostate, the role of androgen receptors in prostate, or other metabolic disorders as possible mechanisms for exacerbation in BPH with COVID-19[ 4 ]. Currently, there is only one case series about this topic in children[ 5 ].…”

Lower Urinary Tract Symptoms in a prospective cohort of COVID-19 survivors

“…Moreover, they did not state how long after acute COVID the patients were evaluated. In another study consisting of a small case series, persistent LUTS and urodynamic abnormalities have been shown months after acute SARS-CoV-2 infection in teenagers (15). Authors proposed that clinicians should be aware of a recent COVID-19 infection in patients with sudden onset lower urinary tract dysfunction.…”