Bladder Dysfunction and Parkinsonism: Current Pathophysiological Understanding and Management Strategies

Abstract

Patients with Parkinson's disease (PD) commonly develop lower urinary tract symptoms (LUTS) as their disease severity progresses. It is a well-established fact that neurodegeneration of the nigrostriatal dopaminergic pathway occurs in PD. This neurochemical deficiency explains many of the motor disturbances encountered in patients with PD. However, the underlying cause of urinary dysfunction present in over half of patients with PD is poorly understood. Without clearly understanding the underlying pathophysiological and neurochemical mechanisms of LUTS associated with PD, treatment strategies are mainly empirical in nature. This review presents the most recent studies and evidence on the pathophysiological mechanisms of PD-related voiding dysfunction and its available therapies.

Factors that lead to hospitalisation in patients with Parkinson disease-A systematic review

“…Urinary tract infections are also common likely due to autonomic abnormalities leading to bowel and bladder dysfunction. Constipation or faecal impaction is another cause which may result in urinary retention and infections …”

Transcutaneous Tibial Nerve Stimulation in the Treatment of Lower Urinary Tract Symptoms and Its Impact on Health-Related Quality of Life in Patients With Parkinson Disease

“…1 Lower urinary tract symptoms (LUTS) occur in 7% to 70% of patients during the course of the disease that negatively influence health-related quality of life medication for at least 3 months prior to enrollment and if the dosage did not change over the duration of their participation in the study. 1 Lower urinary tract symptoms (LUTS) occur in 7% to 70% of patients during the course of the disease that negatively influence health-related quality of life medication for at least 3 months prior to enrollment and if the dosage did not change over the duration of their participation in the study.…”

Neurogenic Causes of Detrusor Underactivity

“…The pathophysiology underlying DU in PD is currently not well understood, although studies have correlated DU to the patient’s overall motor function 57 . Both pseudodyssynergia of the EUS during NDO and bradykinesia of the EUS during the onset of voluntary micturition can occur in PD patients 58 . Both of these EUS abnormalities can lead to impaired detrusor contractility and DU.…”