Idiopathic Parkinson's Disease: Lower Urinary Tract Dysfunctions and Urodynamic Abnormalities

Background: Although the motor symptoms of idiopathic Parkinson's disease (IPD) are well defined, several studies have established that the non motor symptoms of IPD are common and occur across all stages of IPD, underestimated, unrecognized and untreated. Objectives: The aim of this study is to evaluate the urinary symptoms at different stages of IPD severity and its relation to urodynamic parameters. Methods: This study was conducted on 49 patients with probable IPD (according to Hoehn and Yahr staging of IPD severity, 4, 10, 29, 5, 1 cases were classified as stages 1 to 5 respectively) to evaluate their urinary symptoms using international prostate symptom score and urodynamic tests. Results: In this study, the most prevailing urinary symptom in IPD is nocturia (77.5%) followed by urgency (36.7%) and frequency (32.6%). Urodynamic tests revealed detrusor hyperreflexia in 33 patients (67.3%), hyporeflexia in 6 patients (12.2%) and 10 (20.4%) patients with normal detrusor function.The pathological urodynamic parameters, initial void desire volume and maximum bladder capacity were correlated significantly with disease severity and irritative symptoms index score meanwhile obstructive symptoms index score had no significant correlation with any of urodynamic parameters nor disease severity. Total IPSS symptoms score was significantly correlated with quality of life score. The mean of urodynamic parameters did not differ in IPD patients who did or did not receive anticholinergic or dopaminergic drugs. Conclusion: Urinary dysfunctions are common in IPD and deteriorate progressively with the disease severity. Detrusor hyperactivity is the most common urodynamic abnormality found in IPD patients. The irritative urinary symptoms significantly affect quality of life of IPD patients. [Egypt J Neurol Psychiat Neurosurg. 2010; 47(3): 381-386]