Urodynamic Mechanisms Underlying Overactive Bladder Symptoms in Patients With Parkinson Disease
- Author:
Gregory VURTURE
1
;
Benoit PEYRONNET
;
Jose Alberto PALMA
;
Rachael D SUSSMAN
;
Dominique R MALACARNE
;
Andrew FEIGIN
;
Ricardo PALMEROLA
;
Nirit ROSENBLUM
;
Steven FRUCHT
;
Horacio KAUFMANN
;
Victor W NITTI
;
Benjamin M BRUCKER
Author Information
- Publication Type:Original Article
- Keywords: Detrusor overactivity; Parkinsonism; Urinary bladder; Urinary incontinence; Urodynamics
- MeSH: Ambulatory Care Facilities; Diagnosis; Female; Humans; Lower Urinary Tract Symptoms; Male; Nervous System Diseases; Parkinson Disease; Parkinsonian Disorders; Retrospective Studies; Sensation; Urinary Bladder; Urinary Bladder Neck Obstruction; Urinary Bladder, Overactive; Urinary Incontinence; Urodynamics
- From:International Neurourology Journal 2019;23(3):211-218
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To assess the urodynamic findings in patients with Parkinson disease (PD) with overactive bladder symptoms. METHODS: We performed a retrospective chart review of all PD patients who were seen in an outpatient clinic for lower urinary tract symptoms (LUTS) between 2010 and 2017 in a single-institution. Only patients who complained of overactive bladder (OAB) symptoms and underwent a video-urodynamic study for these symptoms were included. We excluded patients with neurological disorders other than PD and patients with voiding LUTS but without OAB symptoms. RESULTS: We included 42 patients (29 men, 13 women, 74.5±8.1 years old). Seven patients (16.7%) had a postvoid residual (PVR) bladder volume >100 mL and only one reported incomplete bladder emptying. Detrusor overactivity (DO) was found in all 42 patients (100%) and was terminal in 19 (45.2%) and phasic in 22 patients (52.4%). Eighteen patients had detrusor underactivity (DU) (42.3%). Later age of PD diagnosis was the only parameter associated with DU (P=0.02). Patients with bladder outlet obstruction (BOO) were younger than patients without BOO (70.1 years vs. 76.5 years, P=0.004), had later first sensation of bladder filling (173.5 mL vs. 120.3 mL, P=0.02) and first involuntary detrusor contraction (226.4 mL vs. 130.4 mL, P=0.009). CONCLUSIONS: DO is almost universal in all patients with PD complaining of OAB symptoms (97.1%). However, a significant percentage of patients also had BOO (36.8%), DU (47%), and increased PVR (16.7%) indicating that neurogenic DO may not be the only cause of OAB symptoms in PD patients.
