Urological Aspects (Dynamic Bladder and Urethral Function, Urinary Tract Stones and Calcifications) in Patients with Alkaptonuria: A Case Control Study

Abstract

Background The main objective of this study is to evaluate bladder, prostate and proximal urethral dynamic function and also to evaluate urinary tract stones and calcifications in patients with alkaptonuria.Methods Thirty-eight patients were prospectively divided into two groups. Study group (A) involved 17 patients of an average age of 42 years (30–63 years). Control group (B) involved 21 patients of an average age of 37 years (31–62 years). All patients from the two groups underwent uroflowmetry assessment (peak flow rate, shape of the flow rate chart and voided volume) and ultrasonography for the kidneys and urinary bladder for two phases (full bladder and empty bladder). Finally, all patients had their prostate gland assessed in regard to calcification, prostatic stones and prostatic urethral stones.Results Group A—Bladder volume ranged between 400 and 520 cc. The peak flow rate was between 7 and 23 ml/sec, with an average of 18.6 ml/sec. Flow rate curves shape were acceptable to normal bell shape curve in 11 patients. Seven patients (41%) had prostate calcification of 5–35% of prostate size.Group B Bladder volume ranged between 290 and 510 cc. The peak flow rate was 8–27 cc/sec with an average of 20 ml/sec. Normal bill shape voiding curves were observed in 17 patients (80%). Four patients (19%) had prostate calcification of 2–12% of prostate size. Renal measurements on ultrasonography were the same in both groups.Conclusion Patients with Alkaptonuria had a slightly reduced peak urinary flow rate compared to the normal control group, but this was not statistically significant. The incidence of prostatic calcification was higher in alkaptonuria patients and they tended to develop prostate calcification at an earlier age than the control group. Regular urological assessment is recommended for all patients with alkaptonuria over the age of 30 years to detect early urological symptoms of the disease.