BB VIRTSATEISSÄ

[Bb]

Lähettäjä: Soijuv Lähetetty: 14.6.2006 6:01

Borreliabakteeri saattaa aiheuttaa erilaisia virtsatieongelmia joko neurologiselta pohjalta esim. virtsaamisvaikeuksina tai suoranaisena infektiona virtsateissä. Neurologiset ja urologiset oireet paranevat hitaasti ja taudin uusiutuminen on tavallista.


Urinary dysfunction in Lyme disease.

AUTHORS:
Chancellor MB; McGinnis DE; Shenot PJ; Kiilholma P; Hirsch IH
AUTHOR AFFILIATION:
Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
SOURCE:
J Urol 1993 Jan;149(1):26-30

ABSTRACT:
Lyme disease, which is caused by the spirochete Borrelia burgdorferi, is associated with a variety of neurological sequelae. We describe 7 patients with neuro-borreliosis who also had lower urinary tract dysfunction. Urodynamic evaluation revealed detrusor hyperreflexia in 5 patients and detrusor areflexia in 2. Detrusor external sphincter dyssynergia was not noted on electromyography in any patient. We observed that the urinary tract may be involved in 2 respects in the course of Lyme disease: 1) voiding dysfunction may be part of neuro- borreliosis and 2) the spirochete may directly invade the urinary tract. In 1 patient bladder infection by the Lyme spirochete was documented on biopsy. Neurological and urological symptoms in all patients were slow to resolve and convalescence was protracted. Relapses of active Lyme disease and residual neurological deficits were common. Urologists practicing in areas endemic for Lyme disease need to be aware of B. burgdorferi infection in the differential diagnosis of neurogenic bladder dysfunction. Conservative bladder management including clean intermittent catheterization guided by urodynamic evaluation is recommended.