Pós-Graduação em Ciências da Saúde, Universidade de Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, Recife 50100-130, Brazil.
Departamento de Medicina Social, Universidade Federal de Pernambuco, Recife 50670-901, Brazil.
Viruses. 2022 Jul 11;14(7):1512. doi: 10.3390/v14071512.
Describing the urodynamic parameters of children aged 3 to 5 years with microcephaly related to congenital Zika syndrome and verifying the association with clinical, imaging and neurological characteristics.
From October 2018 to March 2020, children with Zika-related microcephaly underwent urological, ultrasonographic and urodynamic evaluation. In selected cases, complementary exams such as urethrocystography and scintigraphy were performed. The children also underwent a complete neurological evaluation. To compare frequency between groups, we used Pearson's chi-squared test or Fisher's exact test.
This study evaluated 40 children, of whom 85% were 4 years old, and all had abnormalities on the urodynamic study, with low bladder capacity (92.5%) and detrusor overactivity (77.5%) as the most frequent findings. Only three children had ultrasound abnormalities, but no child had cystographic or scintigraphic abnormalities, and the postvoid residual volume was normal in 80% of cases. In spite of a frequency of 67.5% of intestinal constipation, there was no record of febrile urinary tract infection after the first year of life. All children presented severe microcephaly and at least one neurological abnormality in addition to microcephaly. The homogeneity of the children in relation to microcephaly severity and neurological abnormalities limited the study of the association with the urodynamic parameters.
Urodynamic abnormalities in children aged 3 to 5 years with Zika-related microcephaly do not seem to characterize a neurogenic bladder with immediate risks for the upper urinary tract. The satisfactory bladder emptying suggests that the voiding pattern is reflex.
描述与先天性寨卡综合征相关的 3 至 5 岁小头畸形儿童的尿动力学参数，并验证其与临床、影像和神经特征的相关性。
2018 年 10 月至 2020 年 3 月，对与寨卡病毒相关的小头畸形儿童进行了泌尿科、超声和尿动力学评估。在选择的病例中，进行了尿道膀胱造影和闪烁扫描等补充检查。这些儿童还接受了全面的神经学评估。为了比较组间的频率，我们使用了 Pearson 卡方检验或 Fisher 确切检验。
本研究共评估了 40 名儿童，其中 85%为 4 岁，所有儿童的尿动力学研究均存在异常，最常见的发现是膀胱容量低（92.5%）和逼尿肌过度活动（77.5%）。只有 3 名儿童有超声异常，但没有儿童有膀胱造影或闪烁扫描异常，80%的病例排空后残余尿量正常。尽管有 67.5%的儿童存在肠道便秘，但在生命的第一年没有记录到发热性尿路感染。所有儿童均有严重小头畸形，除小头畸形外，还至少存在一种神经异常。儿童在小头畸形严重程度和神经异常方面的同质性限制了对尿动力学参数相关性的研究。
与寨卡病毒相关的小头畸形 3 至 5 岁儿童的尿动力学异常似乎并不能确定为具有立即对上尿路造成风险的神经源性膀胱。令人满意的膀胱排空表明排尿模式是反射性的。
