title: Pelvic organ dysfunction is more prevalent and severe in MSA-P compared to Parkinson's disease.
abstract: OBJECTIVE
  It is usually difficult to distinguish between idiopathic Parkinson's disease (PD) and parkinsonian-type multiple system atrophy (MSA-P) in the early stage. However, it is important to make a careful early-stage diagnosis. Therefore, we determined whether an examination of pelvic organ dysfunction would be helpful to distinguish between PD and MSA-P.
  
  
  METHODS
  We recruited 61 patients with PD and 54 patients with MSA-P who were examined at our neurology clinic. The mean ages of the patients with PD and MSA-P were 67 and 64 years, respectively. The mean disease duration of both groups was 3.2 years. We administered a questionnaire on pelvic organ dysfunction to the PD and MSA-P groups. The questionnaire had sections focusing on bladder, bowel, and sexual function. Dysfunction, as described in the responses, was evaluated as normal, mild (>once a month), moderate (>once a week), or severe (>once a day). The Mann-Whitney U-test was used for statistical analysis.
  
  
  RESULTS
  Compared with the PD group, the prevalence and severity of pelvic dysfunction in the MSA-P group was significantly higher for urinary urgency (MSA-P 76%, PD 58%, P<0.05), retardation in initiating urination (79%, 48%, P<0.05), prolongation in urination (79%, 72%, P<0.05), and constipation (58%, 31%, P<0.05). The quality-of-life index among pelvic organ dysfunctions indicated that urinary and bowel function was significantly more impaired in the MSA-P group than in the PD group.
  
  
  CONCLUSIONS
  Urinary urgency, retardation in initiating urination, prolongation in urination, and constipation are more prevalent and severe in MSA-P compared to PD.
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan. tatsuya-yamamoto@mbc.nifty.com
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
authors.forename: R
authors.initials: R
authors.lastname: Sakakibara
authors.forename: T
authors.initials: T
authors.lastname: Uchiyama
authors.forename: C
authors.initials: C
authors.lastname: Yamaguchi
authors.forename: F
authors.initials: F
authors.lastname: Nomura
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.forename: M
authors.initials: M
authors.lastname: Yanagisawa
authors.forename: M
authors.initials: M
authors.lastname: Yano
authors.forename: Y
authors.initials: Y
authors.lastname: Awa
authors.forename: T
authors.initials: T
authors.lastname: Yamanishi
authors.forename: T
authors.initials: T
authors.lastname: Hattori
authors.forename: S
authors.initials: S
authors.lastname: Kuwabara
mesh_terms: D000368:Aged; D003248:Constipation / Q000209:etiology* / Q000503:physiopathology; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications* / Q000503:physiopathology; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology; D010388:Pelvis / Q000503:physiopathology*; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D001745:Urinary Bladder Diseases / Q000209:etiology* / Q000503:physiopathology