Voiding Dysfunction in Human Immunodeficiency Virus Infections

Abstract

Purpose We prospectively evaluated the current spectrum of urodynamic pathology in patients infected with human immunodeficiency virus (HIV) who presented with voiding dysfunction. Materials and Methods We obtained a directed genitourinary and neurological history, and performed a physical examination and urodynamic testing in 18 patients. A 4-channel membrane urethral catheter was used to record intravesical and intraurethral pressures simultaneously. Results Detrusor hyperreflexia was present in 28 percent of our patients and detrusor-sphincter dyssynergia in 28 percent. Detrusor areflexia, previously described as the most frequent abnormality, was uncommon in our series (6 percent of patients). Conclusions This changing proportion of urodynamic diagnoses may reflect a changing pattern of neurological manifestations of HIV infection due to more aggressive management. Urodynamic evaluation remains critical for precise diagnosis and treatment in patients with HIV who present with urinary symptoms.