Genitourinary tract problems encountered in human immunodeficiency virus (HIV) infection and/or acquired immunodeficiency syndrome (AIDS) – a review of the literature

Abstract

Background. Acquired immunodeficiency syndrome (AIDS) affects all organs of the genitourinary tract. In view of this, clinicians need to be aware of the ways in which AIDS affects each of these organs. Aim. The aim of this article is to review the literature regarding human immunodeficiency virus (HIV) infections and/or AIDS and its impact on the genitourinary tract. Methods. An internet search was carried out to document the reported associations between HIV infection or AIDS and the urinary tract. The search engines used were Google, Google Scholar and PubMed. Scrutiny of manuscripts which discussed in detail the association between HIV infection or AIDS and the organs of the genitourinary tract formed the basis for the review. Results. The organs of the genitourinary tract may be affected by AIDS in a number of ways, as follows: Urethra A number of patients infected with HIV or suffering from AIDS develop dysuria and urinary frequency as a result of cytomegalovirus infection. Other patients may develop B- or T-cell lymphoma involving the urethra. Prostate Opportunistic infections of the prostate gland may be encountered. Scrotum Atypical organisms associated with Fournier's gangrene may be encountered. Epididymis Opportunistic infections of the epididymis may occur. Testis Opportunistic infections of the testis, testicular atrophy and hypogonadism have been reported. Penis Kaposi's sarcoma and squamous cell carcinoma of the penis have been reported. Bladder Voiding dysfunction and acute retention of urine may develop. Urodynamics may show areflexia, hyporeflexia or hyperreflexia. Ureter Renal colic and ureteric obstruction may result from the deposition of concrements of antiretroviral drugs in the ureter. Kidney Structural renal problems including opportunistic infections, tumours and nephropathy may develop. Functional renal problems may include hyponatraemia, hypokalaemia and acute renal failure. Sexual function Primary or secondary gonadal failure in the HIV-infected patient may result in impotence. Malignancies Kaposi's sarcoma, non-Hodgkin's lymphoma and squamous cell carcinoma may develop. Obstruction of the upper urinary tract may necessitate creation of a nephrostomy. Conclusions A number of genitourinary problems have documented associations with HIV infection and AIDS, including opportunistic infections of genitourinary tract organs; functional and structural renal problems; tumours of the penis, bladder and other organs of the genitourinary tract; voiding problems including urinary retention; ureteric obstruction; and impotence.