Urinary and Sexual Manifestations of Patients Infected by HTLV-I

Abstract

Oliveira P, Castro NM de, Carvalho EM. Urinary and sexual manifestations of patients infected by HTLV-I. Clinics. 2007;62(2):191-6. HTLV-I is considered to be a virus of low morbidity, since the principal diseases associated with this viral infection, HTLV-Iassociated myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukemia/lymphoma (ATLL), are observed in less than 5% of infected individuals. Urinary symptoms are frequent in patients with myelopathy and consist principally of nocturia, frequency, urgency, and urinary incontinence; however, the importance of these dysfunctions and their correlation with myelopathy is still to be fully clarified. This review gives particular emphasis to the high frequency of urinary and sexual complaints not only in patients with myelopathy but also in individuals considered to be HTLV-I carriers. Detrusor overactivity and bladdersphincter dyssynergia are the most common urodynamic findings. The fact that urinary complaints and urodynamic parameters reported in individuals considered to be carriers are similar to those detected in patients with myelopathy supports the hypothesis that urinary disorders may represent an oligosymptomatic form of HAM/TSP. Erectile dysfunction is frequently observed in HTLV-I-infected patients with or without myelopathy. Urinary tract infections are also highly prevalent in these patients. Despite the lack of an effective treatment for myelopathy, the use of anticholinergic drugs and phosphodiesterase type 5 (PDE5) inhibitors may improve urinary complaints and erectile dysfunction in these patients.

Epidemiology, Treatment, and Prevention of Human T-Cell Leukemia Virus Type 1-Associated Diseases

“…Previous studies have described that arthritis, urinary tract disorders, fibromyalgia, and major depression are frequently found in HTLV-1-infected populations (18,63,77,91). Possibly, some of these diseases either share a pathological mechanism with HTLV-1-related diseases or are related to psychological distress due to the infection.…”

O vírus linfotrópico de células T humanos tipo 1 (HTLV-1): Quando suspeitar da infecção?

“…During the initial phases the most common urinary symptoms are nocturia, urge urinary incontinence and dysuria, progressing to feelings of micturition effort, incomplete bladder emptying and incontinence. 44,45,46 Erectile dysfunction is reported in 88.2% of patients with HAM/TSP, in comparison with a rate of 17% in the general population. 44 Rocha et al 47 observed symptoms suggestive of urinary infection in HTLV carriers, but did not confirm infection by urine culture in the majority of cases (81%).…”

Reproductive Decisions among People Living with Human T-cell Lymphotropic Virus Type 1 (HTLV-1)

“…These individuals, who also reported difficulty in using condoms, relayed the understanding that women should submit to their partner´s decisions on the grounds that this "passive" posture was suitable for females in a society still very marked by macho men behaviour [27][28][29]. However, men may have greater difficulty in the use of condoms because one of the first symptoms of HAM/TSP is erectile dysfunction [30]. Taken together, simply orienting the health team to indicate condom use to prevent transmission did not address the specific needs of these individuals.…”