Abstract General Information

Title

UROLOGICAL EVALUATION OF SCHOOL-AGE PATIENTS BORN WITH CONGENITAL ZIKA SYNDROME: MARANHAO'S EXPERIENCE

Introduction and objective

Congenital Zika Syndrome is recognized by severe microcephaly and other anomalies of the central nervous system, making children susceptible to bowel and bladder dysfunction. Neurogenic bladder is one the related morbidities (COSTA MONTEIRO et al. 2019). While most children were evaluated in the first years of life, there is a lack of studies that assess the urological tract of older children affected by the syndrome. This study aims to investigate the bladder function of children with Congenital Zika Syndrome at school age to strengthen urological care for them.

Method

This is a prospective study including children with Congenital Zika Syndrome from 5 years of age, assisted at the University Hospital of the Federal University of Maranhão as part of a research project, supported by a grant from the Brazilian National Council for Scientific and Technological Development, to strengthen urological care for patients affected by the syndrome. Evaluation was based on the protocol for urological investigation of children with Congenital Zika Syndrome (FONTES JM et al. 2021) and performed by a team consisting of a physiotherapist, urologist, and nurse.

Results

Between 2022 and 2023, 22 children with Congenital Zika Syndrome age 5 to 7 years old started urological investigation for the first time in our clinic and all were included. Most were male (72.7%), 50% presented urinary incontinence and 9.1% urinary tract infection. Among the 15 children who underwent urodynamic evaluation, 11 had detrusor overactivity and six had maximum bladder capacity below 50% of that expected for their age. Twelve out of 15 did not adequately emptied their bladder, leaving a post-void residual that ranged from 19% to 100% (mean 45%).

Conclusion

This is the first publication on urodynamic evaluation of school-age children with Congenital Zika Syndrome and it confirmed abnormalities in bladder filling and emptying phases, including reduction in bladder capacity, detrusor overactivity and high post-voiding residue. All are risk factors for urinary infection and incontinence and urological evauation/urodynamic study can help to prevent them.