Avaliação Urodinâmica De Pacientes Chagásicos

Rocha, Jeová Nina; Suaid, Haylton Jorge; Martins, Antônio Carlos Pereira; Cologna, Adauto José; Tucci, S.; Gonçalves, Maiara Aline

doi:10.1590/s0102-86502001000500003

Cited by 1 publication

(3 citation statements)

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“…In their urodynamic study, Rocha et al [9] found voiding dysfunction and hypocontractile bladders, without any urinary sphincter insufficiency; this result was concordant with Suaid et al’s work [8]. Our results, showing a normal urinary sphincter without pudendal denervation in all the groups studied, associated with hypocontractility in 30–60% of the patients presenting a digestive form of the illness, therefore have a good external validation.…”

Section: Discussionsupporting

confidence: 91%

“…The fact that urinary dysfunction seems to appear mostly in patients suffering from the digestive form of the illness was assumed a few decades ago and has been discussed by several authors [8, 9]. The concomitant alteration of these two neighboring organs can be explained by a common physiopathology.…”

Section: Discussionmentioning

confidence: 99%

“…Various studies have previously reported the involvement of the lower urinary tract in experimental chronic Chagas disease [2–6] or in the earliest human studies as described by Koeberle in 1963 on cadaveric specimens [7]. Human symptomatology deriving from bladder, ureteral, and urethral chronic chagasic lesions is as yet widely unknown, and only a few Brazilian studies have intended to describe this clinical and urodynamic presentation [8, 9]. The existing data deriving from animal studies or short human descriptive studies suggest that patients suffering from a digestive form of the disease are more likely to have urinary involvement.…”

Section: Introductionmentioning

confidence: 99%

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

Bey¹,

Condori²,

Gaget³

et al. 2018

World J Urol

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%