title: Retrospective clinic and urodynamic study in the neurogenic bladder dysfunction caused by human T cell lymphotrophic virus type 1 associated myelopathy/tropical spastic paraparesis (HAM/TSP).
abstract: HTLV-I associated tropical spastic paraparesis (TSP) and HTLV-I associated myelopathy (HAM) is an endemic disease in Caribbean Island. Bladder-sphincter dysfunctions are almost present. The objectives of the study are to describe clinic and urodynamic characteristics of voiding disorders in Martiniquan population, evaluate if there is a relationship between motor and urinary handicap, and evaluate prognosis factors of urologic complications.
  
  
  
  Retrospective study of 60 patients suffering from HAM/TSP. Clinical, urodynamic datas, scale of urinary and motor handicap (Urinary Symptom Profile [USP] questionnaire and Osame Score) were collected.
  
  
  
  Storage symptoms were the most frequent (75%) whatever type of detrusor activity. Detrusor overactivity was the most frequent disorder (68.3%). Bladder compliance was normal in half percent of the cases. Urethral activity was increased in 47% of the cases. Detrusor sphincter dysynergia was found in 78% of the cases, post-void residual in 58% of cases. Sixty five percent of the patients present at least one urologic complication (morphologic and/or infectious) but there was no correlation with motor enablement (P = 0.3097), neither urodynamic study (P = 0.432 for detrusor overactivity, P = 0.107 for detrusor underactivity, P = 0.058 for high urethral activity, P = 0.893 for detrusor sphincter dysynergia, P = 0.850 for post-void residual volume), neither with evolution duration of HAM/TSP (P = 0.348). USP score was not in correlation with Osame score (P = 0.07).
  
  
  
  Urologic symptoms are not always in relationship with urodynamic study: a systematic urodynamic study is necessary to evaluate HAM/TSP neurogenic bladder. No clinic or urodynamic criterias are predictive of urologic complications. These patients need a close follow up. Neurourol. Urodynam. 36:449-452, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Rehabilitation Unit, University Hospital Martinique, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Troisgros
authors.affiliation: Rehabilitation Unit, University Hospital Martinique, France.
authors.forename: Jose-Luis
authors.initials: JL
authors.lastname: Barnay
authors.affiliation: Rehabilitation Unit, University Hospital Martinique, France.
authors.forename: Farideh
authors.initials: F
authors.lastname: Darbon-Naghibzadeh
authors.affiliation: Rehabilitation Unit, University Hospital Martinique, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Olive
authors.affiliation: Rehabilitation Unit, University Hospital Martinique, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: René-Corail
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015368:Human T-lymphotropic virus 1; D006801:Humans; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000150:complications*; D012189:Retrospective Studies; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology / Q000821:virology*; D014563:Urodynamics / Q000502:physiology*
keywords: HAM/TSP; motor and urinary handicap; urinary tract symptoms; urologic complications