대상포진 환자에서 발생한 배뇨장애에 대한 후향적 연구

Abstract

Background: Voiding dysfunction is a rare complication of herpes zoster but impairs patients’ quality of life. Objective: We investigated the clinical features and progression of zoster-associated voiding dysfunction based on the clinical presentation of urological symptoms and sites of zoster. We also investigated factors associated with delayed improvement in urological symptoms. Methods: This retrospective study included 54 patients diagnosed with both herpes zoster and voiding dysfunction within a 15-day period at the National Health Insurance Service Ilsan Hospital between March 2000 and April 2019. Urological symptoms included voiding (urinary retention) and storage (cystitis and overactive bladder) symptoms. Results: Patients were aged 22∼92 years (median 68.5 years), including 19 males (35.2%). We observed sacral, thoracic, lumbar, trigeminal, and disseminated zoster (44.4%, 31.5%, 18.5%, 1.9%, and 3.7%, respectively). Thirty-one patients (57.4%) showed voiding symptoms (61.3% with sacral zoster), 18 (33.3%) showed storage symptoms (83.3% with thoracolumbar zoster), and 5 (9.3%) had both symptoms. The median recovery time from urological symptoms was 14.5 days (3∼150 days), significantly longer in patients with voiding symptoms (22 days [5∼150 days]) than with storage symptoms (10 days [3∼35 days]) (p=0.001). Patients with prolonged urological symptoms (＞4 weeks vs. ≤4 weeks) were older (73 years [57∼92 years] vs. 68 years [22∼88 years]), more likely to be male (57.1% vs. 23.7%), and showed persistent pain (35 days [7∼700 days] vs. 23 days [9∼180 days]) (p＜0.05). Conclusion: Voiding dysfunction in patients with zoster warrants attention. Delayed recovery of voiding function is associated with old age, male sex, and persistent pain.