Possible association of urinary incontinence with post-COVID-19: a report of three cases.

INTRODUCTION: The disorder denominated urinary incontinence (UI) has been diagnosed amongst 25-45% of women worldwide. Muscle weakness is one of the more notable symptoms, which is exhibited in the acute form of coronavirus disease 2019 (COVID-19) that compromises the respiratory musculature. Accordingly, this report aims to delineate three cases in women with UI possibly associated with post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. CASE REPORTS: Three elderly Brazilian women expressed UI symptomology post-COVID-19 recovery. In the investigation reports, there was no documented acute impairment or hospitalization post-COVID-19. Nevertheless, some form of UI derived from muscle weakness was detected and treated by physiotherapy in these patients. The patient 1 (P1) was classified as mixed urinary incontinence (MUI) based on the presented symptomology during the filling phase and urinary leakage on exertion. Intravaginal probing suggested neural integrity. The P2 and P3 were classified as stress urinary incontinence (SUI), related to increased abdominal pressure. In all the three cases, there were benefits from physical therapy treatment. CONCLUSIONS: This case report is relevant in improving our understanding and lead to future research about the possibility of clinical variations as UI after infection by SARS COV 2 contributing to greater awareness in the diagnostic workup and allowing for earlier treatment and management. It is concluded that the surveillance of the distinct symptomologies associated with the SARS-CoV-2 infection is fundamental, because there is no adequate corroboratory evidence in the scientific literature, for the cases of pelvic floor muscles weakness that causes UI.

Depletion of enteroendocrine and mucus-secreting cells is associated with colorectal carcinogenesis severity and impaired intestinal motility in rats.

This study investigated the relationship between enteroendocrine and mucus-secreting cells distribution, the severity of colonic mucosal injury and intestinal motility in experimental colorectal carcinogenesis. Using a standardized murine model of colorectal carcinogenesis, eight-weeks-old female Wistar rats weighting 147.30 ± 29.15g were randomized into two groups receiving a subcutaneous injection of 0.9% saline (control) or the chemical carcinogen 1,2-dimethylhydrazine (DMH) at 20 mg/kg per week during 10 weeks. Aberrant crypt foci (ACF) were more frequent in DMH group compared to control group (P < 0.001). The number of enteroendocrine and mucus-secreting cells, and intestinal motility was reduced in DMH animals (P < 0.05). The distribution of enteric neurons was similar in both groups. In DMH animals there was a direct correlation between colonic motility and distribution of enteroendocrine (R(2) = 0.68, P < 0.05) and mucus-secreting cells (R(2) = 0.77, P < 0.05). Inverse correlation between the number of ACF, mucus-secreting cells (R(2) = -0.57, P < 0.05), and enteroendocrine cells (R(2) = -0.74, P < 0.05) was also observed. There was inverse correlation between the severity of the mucosal lesion, the number of mucus-secreting cells (R(2) = -0.83, P < 0.05) and enteroendocrine cells (R(2) = -0.96, P < 0.05). There was a direct correlation between nucleolar organizer regions (AgNOR) and ACF number (R(2) = 0.62; P < 0.01). Inverse correlation was also found between AgNOR, the number of mucus-secreting cells (R(2) = -0.76; P < 0.001), and enteroendocrine cells (R(2) = -0.86; P < 0.001). Taken together, the results indicated that colonic malignant transformation is related to depletion of mucus-secreting and enteroendocrine cells, which was a useful indicator of the evolutionary status of intestinal neoplasm, partially explaining the intestinal motility disorders in the early stages of colorectal carcinogenesis.