Bey E., Paucara Condori M.B., Gaget O., Solano Philippe, Revollo S., Saussine C., Brenière Simone Frédérique. (2019). Lower urinary tract dysfunction in chronic Chagas disease : clinical and urodynamic presentation. In :
Bolton D. (ed.), Frydenberg M. (ed.). Including the topical section : progress in imaging for advanced prostate cancer. World Journal of Urology, 37 (7), p. 1395-1402. ISSN 0724-4983.
Titre du document
Lower urinary tract dysfunction in chronic Chagas disease : clinical and urodynamic presentation
Année de publication
2019
Auteurs
Bey E., Paucara Condori M.B., Gaget O., Solano Philippe, Revollo S., Saussine C., Brenière Simone Frédérique
In
Bolton D. (ed.), Frydenberg M. (ed.), Including the topical section : progress in imaging for advanced prostate cancer
Source
World Journal of Urology, 2019,
37 (7), p. 1395-1402 ISSN 0724-4983
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.
Plan de classement
Epidémiologie des trypanosomiases [052GLOTRY02]
Descripteurs
TRYPANOSOMIASE HUMAINE ; MALADIE DE CHAGAS ; ESSAI CLINIQUE ; DESORDRE URINAIRE
Description Géographique
BOLIVIE
Localisation
Fonds IRD [F B010076401]
Identifiant IRD
fdi:010076401
