Neurogenic bladder in the settings of Congenital Zika Syndrome: a confirmed and unknown condition for urologists
Lucia M. Costa Monteiro, MD, Ph.D. in Medicine, Glaura Cruz, MD, MS.C., Juliana Fontes, MD, MS.C., Tayane Ventura, research student, Grace Araujo, Ph.D., RN.
Instituto Fernandes Figueira/FIOCRUZ, Rio de Janeiro, Brazil.
Background and objective: Congenital Zika Syndrome (CZS) is a new condition that affects Central Nervous System structures that control the lower urinary tract. Initial results (https://doi.org/10.1371/journal.pone.0193514) confirmed neurogenic bladder (NB). The goal is to continue to evaluate NB in the setting of CZS and identify urological risk indicators to mitigate urological impact of the disease.
Methods: Urological assessment (dx.doi.org/10.17504/protocols.io.k5vcy66) was performed in all patients with confirmed CZS referred to our urodynamic clinic between . NB was confirmed by urodynamic evaluation and urological risk was based on urodynamic results.
Findings: Between 2016 and 2018, 67 CZS patients were tested. NB was confirmed in 65 patients, 62 with overactive bladders. The association of reduced bladder capacity, high detrusor filling pressure and PVR were frequently observed. High-risk neurogenic bladder was confirmed in 97% of CZS patients with Congenital Zika syndrome.
Conclusion: Neurogenic bladder was confirmed in the settings of Congenital Zika Syndrome. This is new and unknown for urologists. While further investigation is necessary to understand long-term disease behavior and therapeutic response, the proactive management of neurogenic bladder may help mitigate the disease burden for patients and families.
Figure 1: Overactive bladder on CZS patient. Reduced bladder capacity (13ml), high bladder and leak point pressure (up to 150cm H2O) e 30% PVR.
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