title: Urodynamic features of the voiding dysfunction in HTLV-1 infected individuals.
abstract: OBJECTIVE
  To describe urodynamic abnormalities in HTLV-1 infected individuals presenting urinary symptoms and verify if these findings and quality of life (QOL) evaluation correlate with overall neurological impairment.
  
  
  METHODS
  From January/2001 to May/2004, 324 HTLV-1 seropositive subjects were evaluated to determine the occurrence of urinary symptoms. Urodynamic testing was performed in those who complained of frequency, urgency, or incontinence. They went through a complete clinical, neurological, and urological examination to investigate symptoms and signs of myelopathy. Neurological disability was assessed by Expanded Disability Status Scale (EDSS).
  
  
  RESULTS
  From the 324 patients evaluated, 78 underwent the urodynamic testing. Fifty-seven individuals were females (73.1%) and age ranged from 23 to 76 years (mean=48.7 years; SD +/- 11.6). Urodynamic testing was abnormal in 63 patients (80.8%). The major abnormality was detrusor overactivity (DO), observed in 33 individuals (33/63; 52.4%), followed by detrusor-external sphincter dyssynergia (DESD), diagnosed in 15 subjects (15/63; 25.4%). HAM/TSP patients had significantly more DESD than the HTLV-I carriers (p=0.005; OR=5.5; CI: 1.6 to 19.4). QOL was severely compromised in HAM/TSP patients.
  
  
  CONCLUSIONS
  Prominent urodynamic abnormalities were identified in individuals genuinely considered as HTLV-I carriers, suggesting an early compromise of the urinary tract; whereas HAM/TSP patients presented urodynamic findings, which posed a potential risk to the upper urinary tract (dyssynergia). Urodynamic evaluation should be performed in all HTLV-I-infected individuals with voiding complaints.
authors.affiliation: Section of Immunology, University Hospital, Bahia Federal University, Salvador, Bahia, Brazil. neviton_castro@uol.com.br
authors.forename: Neviton M
authors.initials: NM
authors.lastname: Castro
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Freitas
authors.forename: Waldyr
authors.initials: W
authors.lastname: Rodrigues
authors.forename: Andre
authors.initials: A
authors.lastname: Muniz
authors.forename: Paulo
authors.initials: P
authors.lastname: Oliveira
authors.forename: Edgar M
authors.initials: EM
authors.lastname: Carvalho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000150:complications* / Q000503:physiopathology; D011788:Quality of Life; D012720:Severity of Illness Index; D053201:Urinary Bladder, Overactive / Q000209:etiology* / Q000503:physiopathology; D014555:Urination Disorders / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics