title: [Vesico-sphincteric disorders in patients with Parkinson's disease].
abstract: Vesicosphincteric disorders are frequent in patients with Parkinson's disease, due to a lesion of the locus niger of the extrapyramidal tract which no longer secretes sufficient dopamine to activate the nigrostriatal tract. The commonest symptoms are urgent micturition, dysuria or a combination of the two. 50% of patients with Parkinson's disease present with disturbances of micturition and these symptoms may be presenting complaint of the disease in 10% of cases. Cystomanometry reveals detrusor hyperactivity in more than 60% of cases and hypoactivity in less than 30% of case, while dyssynergia is less common. Delayed relaxation of the striated sphincter may sometimes be observed. Urological problems must therefore be distinguished from urological problems in these patients. A combined urological and urodynamic assessment is essential as the risk of incontinence following prostate surgery is 20%. Stress urinary incontinence in women may mask or be associated with urgency. These vesicosphincteric disorders must therefore be treated cautiously with a combination of medical treatment (dopatherapy increases detrusor control), retraining and occasionally surgery after a detailed urodynamic assessment.
authors.affiliation: Service de Neurologie, Hôpital de Bicêtre.
authors.forename: M
authors.initials: M
authors.lastname: Desi
authors.forename: A
authors.initials: A
authors.lastname: Pelhuche
authors.forename: G
authors.initials: G
authors.lastname: Benoit
mesh_terms: D005260:Female; D006801:Humans; D010300:Parkinson Disease / Q000150:complications* / Q000628:therapy; D001745:Urinary Bladder Diseases / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
vernacular_title: Les troubles vésico-sphinctériens chez le parkinsonien.