[Incontinence--a common issue for people with Parkinson's disease. A systematic literature review]

Parkinson's disease is among the most common neurological diseases. About 4.1 million people are attected worldwide. The course of Parkinson's disease is chronically progressive. With L-Dopa therapy the life expectancy of people being affected by Parkinon's disease is not shortened compared with people who are not affected. Therefore people with Parkinson's disease often suffer from the serious effects for decades which include motor symptoms as well as vegetative disturbance, which concerns bladder function and functions of the gastrointestinal tract. Urinary and fecal incontinence involve severe impairment of quality of life. In this review the occurence of urinary and fecal incontinence should be determined in order to be able to describe its extent. There are different measures for treatment or improvement. These are reviewed based on the following research question: Which effects do interventions have in improving urinary and fecal incontinence in persons with Parkinson's disease compared to usual care? In order to answer the questions a systematic review was conducted. The literature search occured in the electronic databases Cochrane database, PubMed and CINAHL. Three studies investigating the prevalence with a total sample size of n = 1077 and for the evaluation of interventions four studies with a total sample size of n = 48 have been included. 25 percent of the women with Parkinson's disease suffer from urgency incontinence compared to seven percent of the women without Parkinson's disease (p < 0.01). Among men with Parkison's disease 28 percent are affected and six percent among men without Parkinson's disease (p < 0.01). In respect to stress and fecal incontinence there were no significant differences between people affected and people not affected by Parkinson's disease. With pelvic floor muscle exercises and accompanying measures as well as with injections of botulinum toxin A a reduction of urinary incontinence seems to be possible. Due to methodological insufficiency of these studies, no clear recommendations can be given.