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Urinary tract dysfunction in Parkinson's disease: a review
Lehana Yeo1, Rajindra Singh, Mohan Gundeti
1Department of Urology, Barts and The London NHS Trust, London, UK.
International Urology and Nephrology
|May 10, 2011
Summary
Urinary symptoms like urgency and nocturia are common in Parkinson's disease (PD), significantly impacting quality of life. Urodynamic evaluation is key for diagnosing bladder dysfunction in PD patients, differentiating it from conditions like Multiple System Atrophy (MSA).
Area of Science:
- Neurology
- Urology
Background:
- Parkinson's disease (PD) is a neurological disorder primarily known for motor symptoms, but non-motor symptoms, including urinary dysfunction, are prevalent and significantly affect patient quality of life.
- Urinary symptoms such as urgency, frequency, nocturia, and urge incontinence are frequently observed in individuals with Parkinson's disease.
Purpose of the Study:
- To discuss urinary dysfunction in Parkinson's disease patients.
- To explore the pathophysiology, differential diagnoses, investigations, and management options for urinary disturbances in PD.
Main Methods:
- An extensive literature search was conducted using PubMed and EMBASE databases.
- Current national guidelines on Parkinson's disease were also referenced.
Main Results:
- Urinary disturbances are common in Parkinson's disease, with storage symptoms affecting 57-83% and voiding symptoms 17-27% of patients.
- Nocturia is the most frequent complaint (>60%), followed by urgency (33-54%) and frequency (16-36%).
- Detrusor overactivity (DO), a neurogenic bladder abnormality, is found in 45-93% of PD patients. Multiple System Atrophy (MSA) is a key differential diagnosis with similar urinary symptoms.
Conclusions:
- Persistent or refractory urinary complaints in Parkinson's disease patients warrant referral to a urologist.
- Urodynamic evaluation is recommended to determine the underlying bladder disorder, though post-void residuals may suffice in uncomplicated cases.
- Understanding the pathophysiology and employing appropriate investigations and treatments are crucial for managing urinary dysfunction in PD.
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