Voiding dysfunction in patients with Parkinson's disease: impact of neurological impairment and clinical parameters.
OBJECTIVE
We assessed the lower urinary tract symptoms (LUTS) of patients with Parkinson's disease (PD) and their association with different clinical parameters.


METHODS
We prospectively evaluated 110 patients (84 men), with a mean age of 61.8 +/- 9.6 years. Mean duration of the disease was 12.3 +/- 7.2 years. Neurological impairment was assessed by the Hoehn-Yahr and the Unified Parkinson Disease Rating scales. LUTS were assessed by the International Continence Society questionnaire. We evaluated the impact of age, PD duration, neurological impairment, gender, and use of anti-Parkinsonian drugs on the voiding function.


RESULTS
On multivariate analysis, voiding dysfunction increased with the neurological impairment, but not with patient's age or disease duration. Quality of life (QOL) was affected by the severity of LUTS, and the symptoms with the worst impact were frequency and nocturia. Sixty-three (57.2%) patients were symptomatic. They did not differ with the asymptomatic as to age and disease duration, but had more severe neurological impairment. No impact on LUTS was associated with the use of levodopa, anticholinergics, and dopamine receptor agonists. Men and women were similarly affected by urinary symptoms.


CONCLUSIONS
The severity of the neurological disease is the only predictive factor for the occurrence of voiding dysfunction, which affects men and women alike.
Sammour
Zein M
ZM
Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
Gomes
Cristiano M
CM
Barbosa
Egberto R
ER
Lopes
Roberto I
RI
Sallem
Flávio S
FS
Trigo-Rocha
Flavio E
FE
Bruschini
Homero
H
Srougi
Miguel
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology*; D001745:Urinary Bladder Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology
D000978:Antiparkinson Agents