       Document 0309
 DOCN  M9630309
 TI    [Urination disorders in HIV infected patients]
 DT    9603
 AU    Hermieu JF; Mane M; Boccon-Gibod L; Clinique Urologique, Hopital Bichat,
       Paris.
 SO    Presse Med. 1995 Sep 30;24(28):1287-90. Unique Identifier : AIDSLINE
       MED/96096641
 AB    OBJECTIVES: Manifestations of urological involvement, including tumour
       development, infection and impaired micturition are frequent in patients
       with acquired immunodeficiency syndrome. The frequency and consequences
       of dysuria itself are difficult to evaluate due to the concomitant
       effects of underlying infections, obstructive or neurological
       pathologies. METHODS: Thirty-nine HIV-positive patients presenting
       impaired micturition including isolated dysuria, urine retention
       pollakiuria or urge incontinence were followed prospectively from
       February 1989 to September 1992. Each patient underwent a complete
       neurological and urological examination. Imaging included CT-scan or
       magnetic resonance imaging of the brain or spinal cord, echography of
       the bladder and prostate, intravenous pyelography or ascending and
       micturition urethrocystography as required. Urinary function tests were
       used to determine the cause and exact type of impairment to establish
       therapeutic protocols. RESULTS: A neurological origin was found in 61.5%
       of the cases. Cerebral toxoplasmosis and HIV encephalitis were the most
       commonly found causes. Symptomatic relief was obtained in most patients
       with bladder- sphincter active drugs. After a mean follow-up of 9 months
       (range 2-24 months), long-term improvement was achieved in 57.9%.
       Seventeen patients (44%) died within a delay of 2 to 24 months (mean 8
       months) after onset of dysuria. CONCLUSION: Signs of impaired
       micturition are frequently encountered in HIV-infected patients. A full
       work-up is needed for diagnosis and treatment adaptation. Neurological
       disease is the most frequent underlying cause and would appear to be a
       sign of poor prognosis.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adrenergic
       alpha-Antagonists/THERAPEUTIC USE  Adult  Aged  AIDS-Related
       Opportunistic Infections/COMPLICATIONS  Cholinergic
       Antagonists/THERAPEUTIC USE  Drug Therapy, Combination  Encephalitis,
       Viral/*COMPLICATIONS  English Abstract  Female  Human  HIV
       Infections/*COMPLICATIONS  Male  Middle Age  Prospective Studies
       Prostatic Hyperplasia/*COMPLICATIONS  Toxoplasmosis,
       Cerebral/*COMPLICATIONS  Urination Disorders/DRUG
       THERAPY/*ETIOLOGY/PHYSIOPATHOLOGY  Urodynamics  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

