Bladder involvement in Behcet's syndrome

Purpose: We report our clinical experience with Behcet's syndrome and bladd er involvement. Materials and Methods: From April 1991 through July 1996, 7 men and 1 woman 25 to 53 years old with Behcet's syndrome were evaluated for lower urinary tract symptoms (7) or hematuria (1). Of 8 patients 5 had neurological invo lvement. Evaluation consisted of history, physical examination, urinalysis and urine culture, excretory urography, urodynamic studies, urethrocystosco py, bladder biopsies and histopathological examination. Results: Cystoscopy revealed bladder ulcer in 1 patient and an indurated, h ypervascular lesion in another with bilateral hydronephrosis. The most comm on urodynamic finding was detrusor overactivity. Of 4 patients with poor co mpliance 1 had additional sphincteric deficiency. Common histopathological features were moderate and marked thickening of bladder vessel walls. Lymph ocytic vascular reaction was present in 2 patients and lymphocytic vasculit is in 1. Clamshell augmentation ileocystoplasty was performed in 3 patients , including 1 who also underwent a sphincter enhancement procedure. The rem aining 5 patients received various nonsurgical treatment. Conclusions: Various types of voiding dysfunction relating to bladder and s phincteric components in both phases of micturition can be seen in Behcet's syndrome. Voiding dysfunction can be due to either neurological or direct bladder involvement. Augmentation ileocystoplasty is a good treatment optio n for Behcet's syndrome with severe bladder involvement.