title: Bladder function of patients with Parkinson's disease.
abstract: Bladder function of patients with Parkinson's disease alters significantly: the majority of patients have overactive bladder (urinary urgency/frequency) with little or no post-void residuals. This seems to be the result of an altered brain-bladder relationship, as in Parkinson's disease, the frontal-basal ganglia D1 dopaminergic circuit that normally suppresses the micturition reflex is altered. The pathophysiology of the bladder dysfunction in Parkinson's disease differs from that in multiple system atrophy; therefore, it might also aid in differential diagnosis. The effects of levodopa, the major drug to treat motor dysfunction, on the bladder in Parkinson's disease vary significantly; therefore, add-on therapy is often required. Anticholinergic drugs are the first-line treatment, with particular care for cognitive function in elderly patients. The second-line treatment includes serotonergics drug, desmopressin and others. Newer modalities include deep brain stimulation that improves the bladder in Parkinson's disease; and botulinum toxin is promising, particularly in difficult cases. These treatments might be beneficial in maximizing the patients' quality of life.
authors.affiliation: Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.forename: Fuyuki
authors.initials: F
authors.lastname: Tateno
authors.forename: Takeki
authors.initials: T
authors.lastname: Nagao
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yamanishi
authors.forename: Masashi
authors.initials: M
authors.lastname: Yano
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kishi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Tsuyusaki
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Aiba
mesh_terms: D006801:Humans; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology*; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology*; D053201:Urinary Bladder, Overactive / Q000209:etiology* / Q000503:physiopathology*
keywords: Parkinson's disease; bladder function; brain; detrusor overactivity