Urodynamic analysis and treatment of male Parkinson's disease patients with voiding dysfunction

Abstract

Background Parkinson's disease (PD) is an extrapyramidal neurological disorder. Urinary symptoms are frequently present in patients affected by PD. Symptoms such as urgency, frequency, nocturia, and urge incontinence significantly impact the patient's quality of life. We attempted to investigate the urodynamic changes and treatment of male PD patients with voiding dysfunction by means of a review. Methods Comprehensive urodynamic examinations were performed in 141 male patients with PD associated with voiding dysfunction. Appropriate treatments were given to subgroups that were divided based on test results, and the changes in urodynamic parameters as well as the treatment efficacy were observed. Results Detrusor hyperreflexia without bladder outlet obstruction (BOO) was observed in 35 patients, who exhibited significant improvements in the international prostate symptom score (IPSS), maximum flow rate (Qmax), bladder volume at the first desire to void, post-void residual (PVR), and bladder compliance. Detrusor hyperreflexia associated with BOO was observed in 59 patients. The patients exhibited significant improvements in IPSS, Qmax, PVR, and bladder compliance. Detrusor dysfunction without BOO was observed in 19 patients, for whom the IPSS and the bladder volume at the first desire to void were improved after treatment. Detrusor dysfunction with BOO was found in 28 patients, with no significant improvement in the urodynamic parameters after the treatment. Conclusions Urodynamic examination is recommended for male Parkinson's disease patients with voiding dysfunction. Early and effective treatment can improve the bladder function and quality of life of these patients.