title: Distinguishing neurogenic from non-neurogenic detrusor overactivity: a urodynamic assessment of lower urinary tract symptoms in patients with and without Parkinson's disease.
abstract: OBJECTIVE
  To examine the urodynamic (UDS) attributes of detrusor overactivity (DO) in patients with Parkinson's disease in comparison to DO in men without neurologic disease, in whom DO is presumably outlet obstruction induced.
  
  
  METHODS
  The UDS database was reviewed for three groups of patients: group 1, men with lower urinary tract symptoms (LUTS) and no known neurologic condition with DO (n = 22); group 2, men with Parkinson's disease and LUTS (n = 39); and group 3, women with Parkinson's disease and LUTS (n = 18). Statistical analysis was used to compare the UDS parameters and diagnoses among the groups and to test for associations between Parkinson's disease duration, Hoehn and Yahr score, and UDS findings.
  
  
  RESULTS
  Patients with Parkinson's disease had a significantly lower median volume at first detrusor contraction than those with non-neurogenic DO. The percentage of group 1 patients with urge incontinence was significantly lower than that found in the other two groups (9.1% versus 53.8% and 55.6%, P <0.001 and 0.002, respectively). No statistically significant correlation between the duration or severity of Parkinson's disease and UDS parameters was found.
  
  
  CONCLUSIONS
  Men with non-neurogenic LUTS are less likely to have urge incontinence on UDS than either men or women with Parkinson's disease. DO owing to Parkinson's disease occurs earlier during filling compared with non-neurogenic DO, especially in women. The duration and severity of Parkinson's disease are not predictive of the nature or severity of UDS abnormalities.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110, USA.
authors.forename: Gina A
authors.initials: GA
authors.lastname: Defreitas
authors.forename: Gary E
authors.initials: GE
authors.lastname: Lemack
authors.forename: Philippe E
authors.initials: PE
authors.lastname: Zimmern
authors.forename: Richard B
authors.initials: RB
authors.lastname: Dewey
authors.forename: Claus G
authors.initials: CG
authors.lastname: Roehrborn
authors.forename: Padraig E
authors.initials: PE
authors.lastname: O'Suilleabhain
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009122:Muscle Hypertonia / Q000175:diagnosis* / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology; D012189:Retrospective Studies; D001748:Urinary Bladder Neck Obstruction / Q000150:complications* / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis* / Q000209:etiology; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics