Pelvic organ dysfunction is more prevalent and severe in MSA-P compared to Parkinson's disease.
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.
Yamamoto
T
T
Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan. tatsuya-yamamoto@mbc.nifty.com
Sakakibara
R
R
Uchiyama
T
T
Yamaguchi
C
C
Nomura
F
F
Ito
T
T
Yanagisawa
M
M
Yano
M
M
Awa
Y
Y
Yamanishi
T
T
Hattori
T
T
Kuwabara
S
S
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