engleski

Urodynamic abnormalities in patients with Parkinson disease

Introduction Patients with Parkinson disese (PD) oftem experience voiding dysfunction. In male patients it could be caused by PD itself or by bladder outlet obstruction while in female patients causes may be complex and not congruent with symptoms. Subjects and methods In our pilot-study urodynamc testing was performed in 15 patients with PD (9 males, 6 females) and International Prostate Symptom (IPS) score. This score reflects voiding dysfunction, not only prostatic symptoms, thus it can be used in male and female patients. Data on disease severity was obtained using UPDRS and Hoehn and Yahr Scale. Disease duration, age, seks and treatnment with antiparkinsonian drugs were alsdo recorded. Results Urodynamic testing showeddetrusor hyperreflexia in 10 patients, hyporeflexia or areflexia in 2, hyperreflexia with impaired contractile function in 2 and hyperreflexia with detrusor-sphincter disynegia in 1 patient. Severity of voiding disturbance increased with disese severty, with post-void residual urine volume as the parametar showing the best correlation. IPS scores increased with disease severity. Irritative index score correlated with maximum cixtometric capacity and obstructive symptom score with post-void residual urine volume. We found no significant differences regarding age, but obstructive symptoms were prevalent in male patients. Influence of antiparkinsonian drugs was not certain. Conclusion. Voiding dysfunction in patients with PD progressively worsens with advance of disability (Hoeha and Yahr scale>3). Dysfunciton of the striated urethral sphincter and pelvic musculature is often seen in PD and delayed relaxation at the time of initiation of voluntary voiding is the main symptom.

Parkinson's disease; urodynamics

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