Bladder dysfunction due to human T-lymphotrophic virus type I associated myelopathy

Bladder dysfunction is a major complication of human T-lymphotrophic virus type I associated myelopathy (HAM). Four patients (3 females and 1 male, aged between 23 and 44 years), who had suffered from HAM for an average of 6 years complained variously of difficulty in micturition, frequency, bed wetting and/or urge incontinence. They were investigated urodynamically. A significant amount of urine was retained in the bladder of 3 patients. During the storage phase, bladder sensation was well preserved in all 4 patients but severe uninhibited detrusor contractions were observed in 3. At micturition, detrusor contractility was present in 3 and completely lost in 1. Of the 4 patients with HAM, 3 suffered from detrusor hyper-reflexia and 1 from detrusor areflexia.