Urological Dysfunction

Abstract

Symptoms of urinary dysfunction occur frequently with Parkinson’s disease (PD), particularly men. Irritative symptoms, encompassing frequency, urgency, and urge incontinence, are reported in 57 to 83% of patients with PD. Obstructive symptoms, such as hesitancy and weak urinary stream, may be present in 17 to 27% of individuals. Detrusor hyperreflexia is the urodynamic correlate of irritative urinary symptoms. Detrusor areflexia is uncommon in PD; when present, anticholinergic drugs are most often responsible. Coexistent obstructive uropathies may complicate the clinical picture in patients with PD and could produce both obstructive and irritative effects. Urinary dysfunction with PD may also be the result of dysfunctional infravesicular mechanisms like sphincter bradykinesia. Irritative urinary symptoms owing to PD are often responsive to anticholinergic drugs, whereas catheterization may be necessary if the symptoms are obstructive in nature.Key WordsUrinary dysfunctionirritativeobstructivesphincter bradykinesiadetrusor hyperreflexiaanticholinergic drugspontine micturition center