Schistosomal myelopathy as a cause of neurogenic bladder dysfunction

Schistosoma hematobium most commonly affects the bladder and S. mansoni has a predilection for the liver, spleen, and the mesenteric territories. Schistosomal spinal cord involvement is an extremely unusual primary presentation of schistosomiasis, especially in the United States. We report 2 patients with documented schistosomiasis who presented with urinary incontinence as their chief urologic complaint. One patient had no sensorimotor deficit and presented with isolated incontinence as the harbinger of spinal involvement. The other patient presented 5 years after initial exposure, emphasizing the possibility of a long latent period between exposure and onset of symptoms.