Korean J Dermatol.  2021 Jul;59(6):447-455.

A Descriptive Review of Herpes Zoster-Associated Voiding Dysfunction

• Kim SM
• Cho NJ

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.

Keyword

Cystitis; Herpes zoster; Neurogenic bladder; Overactive urinary bladder; Urinary retention