Micturition disorders in Lyme disease can occur by several mechanisms. First, Lyme cystitis can occur because the spirochete directly invades the urinary bladder [9]. The second mechanism is related to neuroborreliosis, such as meningoencephalopathy, transverse myelitis, myeloradiculitis, and demyelinating lesions of the spinal cord. Micturition disorders can appear in diverse forms such as detrusor hyperreflexia, detrusor-sphincter dyssynergia, and detrusor areflexia [8]. A study reported that 11 of 44 Lyme encephalomyelitis patients showed urinary bladder dysfunction [10] and another study reported that 5 out of 7 Lyme encephalomyelitis patients showed detrusor hyperreflexia and the remaining 2 patients showed detrusor areflexia [9]. The present patient showed detrusor areflexia in a urodynamic study.
The neurological symptoms caused by Lyme disease are mostly relieved when patients are treated with antibiotics within an appropriate time period. However, in this case, his voiding dysfunction was not relieved while other neurological symptoms were relieved by a 4-week antibiotic treatment. Judging based on bulbocarvernosus reflex tests and suspected demyelinating lesions in S2-S4 regions, it was assumed that his neurogenic bladder was caused by neuroborreliosis although the patient's urinary bladder tissues were not examined.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547183/
Henriëtte
