Pre- and post-void residual volume in Parkinson's disease patients with urinary urgency, incontinence or nocturia

Our aim was to identify Parkinson's disease (PD) patients with overflow incontinence and to observe trends between pre- and post-void residual volume (PVR) and urinary urgency, incontinence or nocturia in our sample.

As part of our diagnostic evaluation, we measured PVR using a portable bladder scanner in patients with PD at our inpatient facility. The initial measurement was conducted upon admission, and, if increased (PVR > 50 mL), a control measurement was carried out on the same or following day. If the PVR was ≥ 150 mL at follow-up, further control measurements were made immediately before and after micturition. Data on urinary urgency, urinary incontinence and nocturia were retrieved from the non-motor symptoms (NMS) part of the standardized medical history taken at admission.

We identified 117 PD patients with increased PVR (≥ 150 mL) during the 8-month period. Due to limited mobility, cognitive impairment, lack of compliance, or early discharge, we were able to carry out the measurements in only 23 out of 117 patients. The investigated population consisted of these 23 PD patients. Further control measurements were carried out to exclude overflow incontinence. We identified no patients with overflow incontinence in our sample. We found that the voiding volume and the volume before voiding were the highest in the urinary urgency group (234.1 mL and 148.3 mL, respectively), while the PVR was the highest among patients with nocturia (91.9 mL vs. 85.8 mL in urgency and 86.6 mL in incontinence). Notable differences in pre-void, post-void, and voiding volumes were observed between men and women in all subgroups, in favor of male patients in our male-dominant sample. Urinary urgency was the most prevalent (78.3%) lower urinary tract symptom (LUTS), followed by nocturia (65.2%) and urinary incontinence (34.8%). We initially hypothesized a possible association between high PVR and urinary urgency in PD patients, but this could not be confirmed. Although the initial PVR was ≥ 150 mL, repeated controls showed lower values, underlining the importance of PVR controls in PD patients. The average age of the patients with nocturia was somewhat higher and they had higher UPDRS III scores than patients in the other subgroups. We only observed slight differences across the subgroups with regard to pre-void, post-void, and voiding volumes.

The strength of the evaluation is limited by the relatively small sample size. Further studies are needed to clarify the characteristics and possible associations of LUTS subgroups (urgency, incontinence, and nocturia) in PD patients with high PVR.