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. 2019 Jul;37(7):1395-1402.
doi: 10.1007/s00345-018-2512-3. Epub 2018 Oct 9.

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

Elsa Bey  1 , Maria Brigitte Paucara Condori  2 , Olivier Gaget  3 , Philippe Solano  4 , Susana Revollo  2 , Christian Saussine  5 , Simone Frédérique Brenière  4   6
Affiliations

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

Elsa Bey et al. World J Urol. 2019 Jul.

Abstract

Purpose: To describe and give an estimation of the prevalence of urinary disorders in chronic Chagas disease, since most clinical research has been centered on the description of the cardiac and digestive forms.

Methods: To explore this topic, a cross-sectional study was conducted in 137 Bolivian adults of both sexes suffering from symptomatic chronic Chagas disease. All patients presenting confirmed chagasic cardiomyopathy, megacolon or both underwent a urologic symptom questionnaire, uroflowmetry, urinary tract ultrasonography and a creatinine assay. When urinary abnormality was detected, a complete urodynamic study was proposed including cystometry, pressure-flow studies and urethral pressure profile.

Results: Out of all study patients, 35 (26%) had a Chagas cardiomyopathy, 81 (59%) a megacolon, and 21 (15%) a megacolon associated with cardiomyopathy. In all, 63% presented urinary disorders defined by IPSS > 7 and/or ICIQ SF > 1. Among them, 62% were incontinent, mainly by bladder overactivity, and 45% presented grade 2 or 3 renal insufficiency. Of 49 patients, the urodynamic study identified 34 patients with detrusor overactivity (69%), mostly in those with Chagas megacolon. Median bladder functional capacity, urethral closure pressure and bladder compliance had normal values. Moreover, 36% of these patients presented moderate hypocontractility, without significant post-void residual.

Conclusions: This study evidenced lower urinary tract dysfunction in a majority of chronic chagasic patients; those presenting megacolon were more likely to suffer from urinary incontinence. These results strongly suggest including routine urological clinical investigation in chronic Chagas patients, as urinary incontinence due to overactive bladder is frequently observed in this population.

Keywords: Bladder; Chronic Chagas disease; Lower urinary tract; Neurogenic bladder; Trypanosoma cruzi; Urodynamic.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow chart of admission and care provided to patients for urological exploration
Fig. 2
Fig. 2
Main results of urological exploration in chagasic patients presenting cardiomyopathy or megacolon. Note: The bar chart represents the percentages of each patient category
See this image and copyright information in PMC

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References

    1. Bern C. Chagas’ Disease. N Engl J Med. 2015;373:456–466. doi: 10.1056/NEJMra1410150. - DOI - PubMed
    1. Boczko J, Tar M, Melman A, et al. Trypanosoma cruzi infection induced changes in the innervation, structure and function of the murine bladder. J Urol. 2005;173:1784–1788. doi: 10.1097/01.ju.0000154170.87947.b8. - DOI - PubMed
    1. Scremin L, Corbett C, Laurenti M, et al. T. cruzi induces megabladder in experimental Chagas disease. Parasitol Int. 1998;47(Supplement 1):200. doi: 10.1016/S1383-5769(98)80520-5. - DOI
    1. Scremin LH, Corbett CE, Laurenti MD, et al. Megabladder in experimental Chagas disease: pathological features of the bladder wall. Rev Hosp Clínicas. 1999;54:43–46. doi: 10.1590/S0041-87811999000200003. - DOI - PubMed
    1. Jelicks LA, Tanowitz HB. Advances in imaging of animal models of Chagas disease. Adv Parasitol. 2011;75:193–208. doi: 10.1016/B978-0-12-385863-4.00009-5. - DOI - PMC - PubMed