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Urinary dysfunction in tropical spastic paraparesis: preliminary urodynamic survey
1Department of Urology, Columbia-Presbyterian Medical Center, New York, New York.
The Journal of Urology
|September 1, 1993
Summary
Tropical spastic paraparesis, an infection from human T lymphotropic virus type 1 (HTLV-1), often presents with bladder dysfunction. Urodynamic studies reveal detrusor external sphincter dyssynergia in most patients, guiding diagnosis and treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Urology
Background:
- Tropical spastic paraparesis (TSP) is a neurological disorder caused by human T lymphotropic virus type 1 (HTLV-1).
- Bladder dysfunction is a common but often underdiagnosed symptom in TSP patients.
- Understanding urodynamic findings is crucial for managing TSP-related voiding issues.
Purpose of the Study:
- To investigate the urodynamic characteristics of patients diagnosed with tropical spastic paraparesis.
- To identify specific patterns of lower urinary tract dysfunction in TSP.
- To emphasize the importance of urodynamic evaluation for TSP management.
Main Methods:
- Synchronous video-pressure-flow urodynamics were performed on five patients (4 female, 1 male) with TSP.
- Electromyography (EMG) of the urethral sphincter was conducted in three patients.
Main Results:
- Four out of five patients exhibited detrusor external sphincter dyssynergia (DESD).
- One patient presented with detrusor hyperreflexia and a coordinated sphincter contraction.
- Urodynamic findings correlated with the neurological impact of HTLV-1.
Conclusions:
- Urodynamic examination is essential for diagnosing and managing voiding symptoms in patients with tropical spastic paraparesis.
- The high prevalence of DESD highlights a specific urodynamic profile in TSP.
- Early diagnosis through urodynamics facilitates appropriate therapeutic interventions for TSP patients.