Affiliations: [a] Department of Urology, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| [b] Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| [c] Department of Pharmacology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| [d] Department of Neurology, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
Correspondence:
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Correspondence to: Tongwen Ou, Department of Urology, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, No 45 Changchunjie Xichengqu, Beijing 100053, China. Tel.: +86 10 83198899 8447; E-mail: outongwen67@163.com.
Note: [1] These authors contributed equally to this work.
Abstract: Background:Urinary dysfunction is common in Parkinson’s disease (PD) patients and management options are limited. Objective:This study aimed to explore the management of urinary dysfunction by researching the special needs of PD patients. Methods:PD patients with urinary dysfunction who underwent urodynamic testing were recruited from a single center from October 2013 to February 2019. The urinary symptoms, International Prostate Symptom Score and Hoehn–Yahr scale were evaluated. Management was made at the urologists’ discretion with follow-up after three weeks. Urinary symptoms, urodynamics and the management of urinary dysfunction were analyzed. Results:A total of 187 patients with a median age of 66.2 and Hoehn-Yahr scale soccer of 2 were enrolled. Irritative symptoms were more common than obstructive symptoms, while obstructive symptoms were more common in male than female patients, except for incomplete voiding. There were 51% cases of detrusor overactivity, followed by 33% with bladder outlet obstruction, 13% had normal function, 12% had detrusor underactivity, 9% had stress incontinence, 7% had increased bladder sensation and 4% had an acontractile bladder. Tolterodine and tamsulosin were the most common therapeutic agents, respectively prescribed to 38.5% and 27.3% of the patients. Other treatments included catheterization, botulinum toxin A bladder wall injection, transurethral resection of the prostate and urethral dilatation. Urinary symptoms were improved significantly in 74.5% of the patients (p < 0.001), including 27 patients treated with tamsulosin only and 54 patients with tolterodine only. Conclusions:Urinary symptoms and urodynamics were highly variable in PD patients, indicating that most patients may benefit from personalized management.
