[Four cases of urinary dysfunction associated with sacral herpes zoster]

Area of Science:

• Neurology
• Infectious Diseases
• Urology

Background:

• Herpes zoster, caused by Varicella-Zoster virus reactivation, typically affects dermatomes.
• Sacral herpes zoster is uncommon, accounting for only 6.9% of cases.
• Urinary dysfunction associated with herpes zoster is rare, occurring in approximately 0.6% of patients.

Observation:

• This report details four elderly patients (66-84 years) who presented with sacral herpes zoster and subsequent urinary dysfunction.
• Lesions were primarily located in the lumbar and sacral areas, correlating with the observed urinary issues.
• Patients received antiviral medications and alpha-1 adrenergic receptor blockers.

Findings:

• Three patients experienced urinary retention requiring clean intermittent self-catheterization (CIC) for several weeks.
• All four patients demonstrated a complete recovery from urinary dysfunction as their herpes zoster lesions resolved.
• The sacral nerve involvement in herpes zoster was directly linked to the temporary onset of urinary dysfunction.

Implications:

• This case series highlights the potential for sacral herpes zoster to manifest with significant urinary dysfunction in the elderly.
• Prompt diagnosis and management, including antiviral therapy and symptomatic treatment for urinary retention, are crucial for favorable outcomes.
• Understanding the neuro-urological complications of Varicella-Zoster virus reactivation can improve patient care and management strategies.