[Vesico-sphincteric disorders in patients with Parkinson's disease].
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.
Desi
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M
Service de Neurologie, Hôpital de Bicêtre.
Pelhuche
A
A
Benoit
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G
D005260:Female; D006801:Humans; D010300:Parkinson Disease / Q000150:complications* / Q000628:therapy; D001745:Urinary Bladder Diseases / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
Les troubles vésico-sphinctériens chez le parkinsonien.