Effects of dopaminergic treatment on bladder function in Parkinson's disease

Abstract

The effects of dopaminergic treatment on bladder control and urodynamic parameters are unpredictable in the individual patient, though most patients experience significant changes. We have also demonstrated the complexity of bladder control, and that patients with PD may be particularly susceptible to develop complex micturitional dysfunction. Our data indicates that cortical dysfunction may play a significant role in bladder dysfunction in PD parallel to the pontine lesion.

Lower urinary tract symptoms and bladder control in advanced Parkinson's disease: Effects of deep brain stimulation in the subthalamic nucleus

“…15 We have previously used this questionnaire in patients with PD. 3,8,16 The IPSS questionnaire consists of seven questions on LUTS and an additional question on general satisfaction of urinary conditions. Symptoms are scored on a frequency scale from 0 to 5.…”

“…In the DanPSS, the total score is calculated as ⌺ 1-12 (symptom score ϫ bother score), thereby including bother of symptoms in the total assessment of LUTS. Questions in DanPSS are in three categories: (1) symptoms of obstructed voiding (questions 1-4 [DanPSS [1][2][3][4] ]), (2) symptoms of (neurogenic) overactive bladder or irritative symptoms (questions 5-8 [DanPSS [5][6][7][8] ]), 14 and (3) symptoms of pain, dripping, and stress incontinence (questions 9 -12).…”

“…4,6 Medical antiparkinsonian treatment may influence bladder control, but in an unpredictable manner. 7,8 Studies in animal models 9 and in humans 10,11 suggest beneficial effects on storage of urine by stimulation in the STN. The aim of this study was to evaluate LUTS and bladder control in patients with Parkinson's disease, in a prospective manner before and after implantation of electrodes in the STN.…”

Nonmotor outcomes in Parkinson’s disease: is deep brain stimulation better than dopamine replacement therapy?

“…This is improved by chronic DRT with a D1-and D2-receptor-mediated increase in volume at which patients recognize bladder filling [Brusa et al 2007]. This effect of DRT is unclear and unpredictable in individual patients [Winge et al 2004]. STN-DBS has been shown to have variable results.…”

Botulinum A Toxin Intravesical Injections in the Treatment of Refractory Overactive Bladder in Patients with Parkinson's Disease

“…The unpredictable effect of medication is not related to stage of disease, age, or whether the patient had symptoms of bladder dysfunction (Winge et al, 2002). In the study of Winge and colleagues (Winge et al, 2004), the authors suggested that the effects of medication are mediated through cortical mechanisms, as the ability to separate and integrate sensory input measured using urodynamics is influenced by medication.…”