Association between motor symptom severity and urinary dysfunction in Parkinson's disease: a retrospective study

Urinary dysfunction is a common non-motor symptom in patients with Parkinson's disease (PD) and is often associated with greater motor disability and reduced quality of life. Despite its clinical relevance, the association between motor symptom severity and urinary dysfunction remains poorly understood. This study aimed to elucidate this relationship using validated clinical questionnaires to assess urinary symptoms.

We conducted a single-center, retrospective cross-sectional study including 223 patients with PD who visited a university hospital between September 2023 and February 2024. Urinary dysfunction was evaluated using the Overactive Bladder Symptom Score (OABSS) and International Prostate Symptom Score (IPSS), comprising the symptom (IPSS-symptom score; Q1-7) and satisfaction (IPSS-satisfaction score; Q8) scores. We analyzed the changes in urinary symptoms, overall satisfaction, and prodromal symptoms across the Hoehn and Yahr (HY) stages. Patients were divided into early (HY ≤ 2) and late (HY > 2) groups to assess early urinary symptom changes.

The OABSS, IPSS-symptom score, and IPSS-satisfaction score significantly increased with advancing HY stage. Compared to the early group, the late group exhibited significantly higher OABSS (p = 0.015), IPSS-symptom scores (p = 0.002), and IPSS-satisfaction scores (p < 0.001). Subgroup analysis of the IPSS revealed that storage symptoms compared with voiding symptoms correlated more strongly with motor severity.

Our study provides evidence that urinary dysfunction intensifies with motor symptom progression in PD. These findings highlight the importance of early detection and proactive management of urinary symptoms in patients with PD to enhance their overall quality of life.