Urogenital symptoms in Parkinson's disease and multiple system atrophy-Parkinsonism: at onset and later.
METHODS
One hundred and eighty-one parkinsonian patients were evaluated to determine if urogenital symptoms at presentation to the Neurology clinic can differentiate them as PD or MSA-P. An autonomic questionnaire was used to document urinary and genital symptoms.


RESULTS
Mean age at presentation and disease duration in PD and MSA-P were similar. Urinary symptoms occurred twice as frequently in MSA-P than in PD. Storage symptoms (frequency, urgency, urge incontinence, nocturia) were common in both Parkinsonian disorders. Male MSA-P reported genital symptoms (erectile and ejaculatory failure) three times more frequently than in PD.


CONCLUSIONS
Urogenital symptoms occurred in MSA-P when they had mild motor few symptoms unlike in PD where they occur when motor symptoms were severe. Urogenital dysfunction occurred early and was present in all MSA-P patients within two years. Presence of urogenital symptoms in early stages of Parkinsonism strongly favors MSA-P rather than PD. Absence of urogenital symptoms in advanced Parkinsonism makes MSA-P unlikely.
Swaminath
Pazhayannur V
PV
Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
Ragothaman
Mona
M
Koshy
Suma
S
Sarangmath
Nagaraja
N
Adhyam
Mohan
M
Subbakrishna
D K
DK
Mathias
Christopher J
CJ
Muthane
Uday B
UB
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D020734:Parkinsonian Disorders / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D011446:Prospective Studies; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D001745:Urinary Bladder Diseases / Q000209:etiology* / Q000503:physiopathology; D014555:Urination Disorders / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics