engleski

Urodynamic abnormalities in patients with Parkinson disease

Introduction Patients with Parkinson disease (PD) often experience voiding dysfunction. In male patients it could be caused by PD itself or by bladder outlet obstruction, while in female patients causes may be complex and not congruent with symptoms. Subjects and methods In our pilot-study urodynamic testing was performed in 15 patients with PD (9 males, 6 females) and International Prostate Symptom (IPS) score. This score reflects voiding dysfunction, not only prostatic symptoms, thus it can be used in male and female patients. Data on disease severity was obtained using UPDRS and Hoehn and Yahr Scale. Disease duration, age, sex and treatment with antiparkinsonian drugs were also recorded. Results Urodynamic testing showed detrusor hyperreflexia in 10 patients, hyporeflexia or areflexia in 2, hyperreflexia with impaired contractile function in 2 and hyperreflexia with detru-sor-sphincter dysynergia in 1 patient. Severity of voiding disturbances increased with disease severity, with post-void residual urine volume as the parameter showing the best correlation. IPS scores increased with disease severity. Irritative index score correlated with maximum cystometric capacity and obstructive symptom score with post-void residual urine volume. We found no significant differences regarding age, but obstructive symptoms were prevalent in male patients. Influence of antiparkinsonian drugs was not certain. Conclusions Voiding dysfunction in patients with Parkinson disease progressively worsens with advancing of disability (Hoehn and Yahr Scale >3). Dysfunction of the striated urethral sphincter and pelvic musculature is often seen in PD, and delayed relaxation at the time of initiation of voluntary voiding is the main symptom.

Parkinson disease; urodynamics

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