Bladder involvement in systemic sclerosis: urodynamic and histological evaluation in 23 patients

Area of Science:

• Rheumatology
• Urology
• Nephrology

Background:

• Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by fibrosis, vasculopathy, and immune dysregulation.
• Lower urinary tract involvement in SSc is considered uncommon, with limited data on its clinical presentation and pathophysiology.
• Understanding vesical changes in SSc is crucial for comprehensive patient management.

Observation:

• This study investigated functional and morphologic vesical changes in 23 female patients diagnosed with systemic sclerosis.
• The research aimed to correlate bladder dysfunction with the extent of skin sclerosis and the severity of internal organ involvement.
• Clinical evaluation included symptom assessment and urodynamic studies.

Findings:

• Urodynamic alterations were identified in only 3 out of 23 patients, indicating low prevalence of significant bladder dysfunction.
• No significant correlation was found between urinary symptoms or urodynamic findings and the degree of vesical fibrosis.
• Furthermore, no association was observed between bladder dysfunction and the severity of visceral organ involvement in SSc patients.
• Autonomic dysfunction was detected in 13 patients, suggesting a potential role in SSc-related uropathy.

Implications:

• The findings suggest that significant lower urinary tract dysfunction is not a common manifestation of systemic sclerosis.
• Autonomic dysfunction may play a role in the urologic symptoms experienced by some SSc patients.
• Further research is warranted to elucidate the mechanisms of vesical changes and autonomic dysfunction in SSc.