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Acute urinary retention attributable to sacral herpes zoster
1Department of Surgery, Antrim Area Hospital, 45 Bush Road, Antrim BT28 3QE, Northern Ireland. achesonjonny@hotmail.com
Emergency Medicine Journal : EMJ
|October 22, 2004
Summary
Acute urinary retention, uncommon in women, can be caused by herpes zoster infection. This case highlights the link between sacral nerve zoster and bladder dysfunction, emphasizing a rare but serious complication.
Area of Science:
- Urology
- Neurology
- Infectious Diseases
Background:
- Acute urinary retention (AUR) is a rare condition in women, often presenting with significant suprapubic pain and bladder distension.
- Herpes zoster, commonly known as shingles, typically affects sensory nerves and causes a characteristic rash.
Observation:
- A 63-year-old woman presented with acute urinary retention (2000 ml residual volume), suprapubic pain, and a palpable bladder.
- The patient also exhibited multiple grouped vesicles on her right buttock, indicative of a dermatomal rash.
Findings:
- The case demonstrates a direct correlation between herpes zoster infection affecting the sacral nerves (S2-S4) and the subsequent development of acute urinary retention.
- This suggests that sacral nerve involvement in herpes zoster can lead to detrusor muscle dysfunction and urinary retention.
Implications:
- This case broadens the understanding of potential neurological complications of herpes zoster, extending beyond typical neuropathic pain.
- Clinicians should consider herpes zoster infection of the sacral nerves in the differential diagnosis of acute urinary retention in women, especially when accompanied by a compatible rash.
- Early recognition and management of sacral herpes zoster may prevent or mitigate severe urinary retention and its sequelae.