Lower urinary tract dysfunction in chronic Chagas disease: clinical and urodynamic presentation

Area of Science:

• Urology
• Infectious Diseases
• Gastroenterology

Background:

• Chronic Chagas disease primarily affects cardiac and digestive systems.
• Urinary disorders in chronic Chagas disease are understudied.
• Understanding urological manifestations is crucial for comprehensive patient care.

Purpose of the Study:

• To estimate the prevalence of urinary disorders in chronic Chagas disease patients.
• To investigate the relationship between Chagasic megacolon and urinary dysfunction.
• To highlight the need for urological assessment in Chagas disease management.

Main Methods:

• Cross-sectional study of 137 Bolivian adults with symptomatic chronic Chagas disease.
• Urologic symptom questionnaires, uroflowmetry, ultrasonography, and creatinine assays were performed.
• Urodynamic studies were conducted for patients with detected urinary abnormalities.

Main Results:

• 63% of patients had urinary disorders (IPSS > 7 and/or ICIQ SF > 1).
• 62% experienced urinary incontinence, primarily due to bladder overactivity.
• 45% had renal insufficiency (grade 2 or 3); 69% of those with urodynamics showed detrusor overactivity, particularly with megacolon.

Conclusions:

• Lower urinary tract dysfunction is prevalent in chronic Chagas disease.
• Chagasic megacolon is associated with a higher likelihood of urinary incontinence.
• Routine urological investigation is recommended for chronic Chagas patients due to frequent overactive bladder and incontinence.