title: Bladder function in patients with dystonia undergoing deep brain stimulation.
abstract: BACKGROUND
  Neurogenic bladder dysfunction is well described in Parkinson's disease and has a major impact on quality of live. In contrast, little is known about the extent of urinary symptoms in other movement disorders such as dystonia and about the role of the basal ganglia in bladder control..
  
  
  METHODS
  A consecutive series of 11 patients with severe dystonia undergoing deep brain stimulation (DBS) of the globus pallidus internus was prospectively enrolled. Bladder function was assessed by the International Prostate Symptom Score and urodynamic investigation (UDI) before DBS surgery and afterwards in the conditions with and without DBS.
  
  
  RESULTS
  In UDI before DBS surgery, detrusor overactivity was found in 36% (4/11) of dystonia patients. With pallidal DBS ON, maximum flow rate significantly decreased, post-void residual significantly increased and detrusor overactivity disappeared..
  
  
  CONCLUSIONS
  Pathological urodynamic changes can be found in a relevant percentage of dystonia patients. Pallidal DBS has a relaxing effect on detrusor function indicating a role of the basal ganglia in lower urinary tract control. Thus, a better understanding on how subcortical networks influence lower urinary tract function might open new therapeutic perspectives..
authors.affiliation: Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. Electronic address: livio.mordasini@kssg.ch.
authors.forename: Livio
authors.initials: L
authors.lastname: Mordasini
authors.affiliation: Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland. Electronic address: tkessler@gmx.ch.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Kessler
authors.affiliation: Department of Urology, University of Bern, Bern, Switzerland. Electronic address: bernhard.kiss@insel.ch.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kiss
authors.affiliation: Movement Disorders Center, Department of Neurology, University of Bern, Bern, Switzerland. Electronic address: michael.schuepbach@insel.ch.
authors.forename: Michael
authors.initials: M
authors.lastname: Schüpbach
authors.affiliation: Department of Neurosurgery, University of Bern, Bern, Switzerland. Electronic address: claudio.pollo@insel.ch.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pollo
authors.affiliation: Neurocenter of Southern Switzerland, Lugano, Switzerland. Electronic address: alain.kaelin@eoc.ch.
authors.forename: Alain
authors.initials: A
authors.lastname: Kaelin-Lang
mesh_terms: D000328:Adult; D000368:Aged; D001479:Basal Ganglia; D046690:Deep Brain Stimulation; D004421:Dystonia / Q000628:therapy*; D020821:Dystonic Disorders / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D001743:Urinary Bladder / Q000503:physiopathology*; D053201:Urinary Bladder, Overactive / Q000628:therapy
keywords: Bladder function; Deep brain stimulation; Dystonia; Urodynamics