title: Urogenital symptoms in Parkinson's disease and multiple system atrophy-Parkinsonism: at onset and later.
abstract: 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.
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
authors.forename: Pazhayannur V
authors.initials: PV
authors.lastname: Swaminath
authors.forename: Mona
authors.initials: M
authors.lastname: Ragothaman
authors.forename: Suma
authors.initials: S
authors.lastname: Koshy
authors.forename: Nagaraja
authors.initials: N
authors.lastname: Sarangmath
authors.forename: Mohan
authors.initials: M
authors.lastname: Adhyam
authors.forename: D K
authors.initials: DK
authors.lastname: Subbakrishna
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Mathias
authors.forename: Uday B
authors.initials: UB
authors.lastname: Muthane
mesh_terms: 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