Prevalence of bladder dysfunction in Parkinsons disease

Prevalence of lower urinary tract symptoms (LUTS) in Parkinsons disease (PD) is reported as 27%-39% based on validated questionnaires which do not consider the degree of bother. To estimate the prevalence of LUTS in patients with PD, the severity of symptoms, the volume of postmicturitional urine, and to estimate differences compared to non-PD patients referred for urological evaluation.

One hundred seven patients with PD were evaluated using two sets of validated questionnaires (Dan-PSS and IPSS) about LUTS; postmicturitional residual urine was recorded, and compared to 61 patients without PD presenting at an urological clinic for examination.

Bothersome LUTS measured using Dan-PSS scores correlated significantly with Hoehn and Yahr stage of disease (P = 0.02), but not with duration of disease or age. IPSS scores did not correlate to stage of disease, duration of disease or age. Two arbitrary cut-offs were applied, identifying patients with significant LUTS, Dan-PSS > 10 and IPSS > 10. There were no significant differences between the age or duration of disease of patients with and without significant LUTS. The most frequent symptom was nocturia (IPSS: 86%) followed by frequency (IPSS: 71%) and urgency (IPSS: 68%). The most frequently reported bothersome bladder symptom was urgency (Dan-PSS: 61%), followed by nocturia (Dan-PSS: 50%) and urge incontinence (Dan-PSS: 44%). The prevalence of bothersome frequency is low (Dan-PSS: 37%). The postmicturitional volumes (PMV) did not correlate to stage of disease, duration of disease or age, or to scores on questionnaires. Mean PMV was 34 ml. Seven patients (6%) with PD had a PMV larger then 100 ml.

The prevalence of severe LUTS was similar with other studies, but the correlation between Dan-PSS and stage of disease, and not IPSS indicates that despite seeing no increase in frequency and severity of LUTS as PD progresses, patients find symptoms more bothersome. This may be due to progression in gait difficulties or a decreasing ability to separate and integrate sensory input, or both.