title: Prevalence and treatment of LUTS in patients with Parkinson disease or multiple system atrophy.
abstract: The lower urinary tract is controlled by complex neural mechanisms not only in the periphery, but also in the central nervous systems (CNS). Thus, patients with a wide variety of neurological diseases often also have lower urinary tract symptoms (LUTS), including those with Parkinson disease (PD) or multiple system atrophy (MSA). LUTS are common comorbidities associated with both of these neurodegenerative diseases and are likely to impair patients' quality of life. The motor symptoms of PD and MSA often seem similar; however, the pathophysiology, and thus the treatment of LUTS differs considerably. Antimuscarinics are the first-line treatment of storage LUTS in patients with PD or MSA; however, care should be taken in the management of these patients, especially in those with MSA owing to the high risk of inefficient voiding, and thus an increased post-void residual volume. Other treatments of PD-related LUTS include α-adrenoceptor antagonists, which improve voiding dysfunction, transurethral resection of the prostate for bladder outlet obstruction owing to prostate enlargement, and neuromodulation and intradetrusor botulinum toxin injections for storage LUTS. However, more conservative treatments, including intermittent catheterization, are required for LUTS in patients with MSA, owing to the high incidence of impaired detrusor contractility and detrusor-sphincter dyssynergia.
authors.affiliation: Department of Urology, Shinshu University, School of Medicine, Matsumoto, 390-8621, Japan.|Department of Urology, University of Pittsburgh School of Medicine, Suite 700 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Ogawa
authors.affiliation: Department of Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, 285-8741, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.affiliation: Neuroscience Institute, National Center of Neurology and Psychiatry, Kodaira, 187-8551, Japan.
authors.forename: Sadako
authors.initials: S
authors.lastname: Kuno
authors.affiliation: Department of Urology, Shinshu University, School of Medicine, Matsumoto, 390-8621, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishizuka
authors.affiliation: Department of Urology, University of Pittsburgh School of Medicine, Suite 700 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Takeya
authors.initials: T
authors.lastname: Kitta
authors.affiliation: Department of Urology, University of Pittsburgh School of Medicine, Suite 700 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshimura
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D019578:Multiple System Atrophy / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D015995:Prevalence; D016896:Treatment Outcome
chemical_list: D000317:Adrenergic alpha-Antagonists; D015259:Dopamine Agents; D018727:Muscarinic Antagonists