Int Neurourol J.  2019 Sep;23(3):211-218. 10.5213/inj.1938086.043.

Urodynamic Mechanisms Underlying Overactive Bladder Symptoms in Patients With Parkinson Disease

Affiliations
  • 1Department of Urology, New York University School of Medicine, New York, NY, USA. Benjamin.brucker@nyulangone.org
  • 2Department of Urology, University of Rennes, Rennes, France.
  • 3Department of Neurology Dysautonomia Center, New York University School of Medicine, New York, NY, USA.
  • 4The Marlene & Paolo Fresco Institute for Parkinson’s & Movement Disorders, New York University School of Medicine, New York, NY, USA.

Abstract

PURPOSE
To assess the urodynamic findings in patients with Parkinson disease (PD) with overactive bladder symptoms.
METHODS
We performed a retrospective chart review of all PD patients who were seen in an outpatient clinic for lower urinary tract symptoms (LUTS) between 2010 and 2017 in a single-institution. Only patients who complained of overactive bladder (OAB) symptoms and underwent a video-urodynamic study for these symptoms were included. We excluded patients with neurological disorders other than PD and patients with voiding LUTS but without OAB symptoms.
RESULTS
We included 42 patients (29 men, 13 women, 74.5±8.1 years old). Seven patients (16.7%) had a postvoid residual (PVR) bladder volume >100 mL and only one reported incomplete bladder emptying. Detrusor overactivity (DO) was found in all 42 patients (100%) and was terminal in 19 (45.2%) and phasic in 22 patients (52.4%). Eighteen patients had detrusor underactivity (DU) (42.3%). Later age of PD diagnosis was the only parameter associated with DU (P=0.02). Patients with bladder outlet obstruction (BOO) were younger than patients without BOO (70.1 years vs. 76.5 years, P=0.004), had later first sensation of bladder filling (173.5 mL vs. 120.3 mL, P=0.02) and first involuntary detrusor contraction (226.4 mL vs. 130.4 mL, P=0.009).
CONCLUSIONS
DO is almost universal in all patients with PD complaining of OAB symptoms (97.1%). However, a significant percentage of patients also had BOO (36.8%), DU (47%), and increased PVR (16.7%) indicating that neurogenic DO may not be the only cause of OAB symptoms in PD patients.

Keyword

Detrusor overactivity; Parkinsonism; Urinary bladder; Urinary incontinence; Urodynamics

MeSH Terms

Ambulatory Care Facilities
Diagnosis
Female
Humans
Lower Urinary Tract Symptoms
Male
Nervous System Diseases
Parkinson Disease*
Parkinsonian Disorders
Retrospective Studies
Sensation
Urinary Bladder
Urinary Bladder Neck Obstruction
Urinary Bladder, Overactive*
Urinary Incontinence
Urodynamics*
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