Herpes zoster-associated voiding dysfunction: a retrospective study and literature review.
OBJECTIVE
(1) To describe the demographic features of patients with voiding dysfunction associated with herpes zoster; (2) to discuss the pathophysiology of voiding dysfunction associated with herpes zoster; and (3) to suggest the best management policy.


METHODS
A retrospective study.


METHODS
A university-affiliated medical center in Taiwan.


METHODS
Four hundred twenty-three patients (mean age, 55.5y) admitted with the diagnosis of herpes zoster from 1988 to 2000.


METHODS
Not applicable.


METHODS
Dermatomal distribution of skin eruptions, urologic symptoms, treatment (catheterization, urecholine), clinical course of voiding dysfunction, and outcome.


RESULTS
Seventeen (mean age, 61.2+/-14.1y) of 423 patients (4.02%) with voiding dysfunction related to this virus infection were identified. Ten (58.8%) were men, and 7 (41.2%) were women. The incidence of dysfunction was as high as 28.6% if only lumbosacral dermatome-involved patients were considered. We classified urologic manifestations caused by herpes zoster into 3 groups: cystitis-associated (n=12), neuritis-associated (n=4), and myelitis-associated (n=1). Urinalysis revealed pyuria in all patients with cystitis-associated voiding dysfunction and microscopic hematuria in all patients with neuritis-associated voiding dysfunction. All patients, although receiving different treatment regimens for voiding dysfunction, regained a normal or balanced bladder within 8 weeks. No major urologic sequelae were noted.


CONCLUSIONS
Voiding dysfunction, although a transient course, is not uncommon in patients with herpes zoster involving lumbosacral dermatomes. Treatment with intermittent catheterization (our preferred choice) or indwelling catheter placement is recommended if the patients have prolonged difficulty in urination. This disease entity usually has a benign clinical course, and almost every patient will either regain normal voiding or, at least, balanced bladder function.
Chen
Po-Hong
PH
Department of Physical Medicine and Rehabilitation, Kuo General Hospital, Tainan, Taiwan. vspmnr70@yahoo.com.tw
Hsueh
Hsiu-Fang
HF
Hong
Chang-Zern
CZ
D000046:Academic Medical Centers; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D018723:Bethanechol / Q000627:therapeutic use; D003556:Cystitis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy / Q000821:virology*; D003937:Diagnosis, Differential; D004568:Electrodiagnosis; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D010277:Parasympathomimetics / Q000627:therapeutic use; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan; D016482:Urinalysis; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy / Q000821:virology*; D014546:Urinary Catheterization; D014563:Urodynamics
D000998:Antiviral Agents; D010277:Parasympathomimetics; D018723:Bethanechol; D000212:Acyclovir