Urodynamic evaluation of calcified bilharzial bladders

Area of Science:

• Urology
• Parasitology
• Medical Histology

Background:

• Schistosomiasis, also known as bilharziasis, is a parasitic disease that can affect the bladder.
• Bladder calcification is a known complication of chronic schistosomiasis.
• The impact of bladder calcification on bladder function remains incompletely understood.

Purpose of the Study:

• To urodynamically assess bladder function in patients with bilharzial calcification.
• To compare bladder function in bilharzial patients with healthy controls.
• To investigate the histological distribution of calcification within the bladder wall.

Main Methods:

• Urodynamic studies including uroflowmetry, fluid cystometry, and pressure-flow studies were performed.
• Cystoscopy and multiple deep bladder biopsies were conducted.
• Histological examination of bladder biopsies was performed to assess calcification patterns.

Main Results:

• No significant differences in overall urodynamic parameters were observed between bilharzial patients and controls.
• Bilharzial patients exhibited significantly higher residual urine volumes (mean 100 ml) and delayed first sensation (mean 250 ml).
• Histology revealed calcification predominantly in the mucosa and submucosa, with rare involvement of the muscle layers.

Conclusions:

• Severe bladder calcification due to bilharziasis does not compromise detrusor muscle function.
• The primary functional impact observed is increased residual urine and altered sensation, likely due to mucosal and submucosal changes.