VOIDING DYSFUNCTION IN HUMAN-IMMUNODEFICIENCY-VIRUS INFECTIONS

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 ob tained a directed genitourinary and neurological history, and performe d a physical examination and urodynamic testing in 18 patients. A 4-ch annel membrane urethral catheter was used to record intravesical and i ntraurethral pressures simultaneously. Results: Detrusor hyperreflexia was present in 28% of our patients and detrusor-sphincter dyssynergia in 28%. Detrusor areflexia, previously described as the most frequent abnormality, was uncommon in our series (6% of patients). Conclusions : This changing proportion of urodynamic diagnoses may reflect a chang ing pattern of neurological manifestations of HIV infection due to mor e aggressive management. Urodynamic evaluation remains critical for pr ecise diagnosis and treatment in patients with HIV who present with ur inary symptoms.