Management of neurogenic bladder in patients with Parkinson's disease: A systematic review

Abstract

Aims:To assess the different treatment methods in management of neurogenic bladder (NGB) in patients with Parkinson's disease (PD). Methods: A systematic search was performed in Cochrane library, EMBASE, Proquest, Clinicaltrial.gov, WHO, Google Scholar, MEDLINE via PubMed, Ovid, ongoing trials registers, and conference proceedings in November 11, 2017. All randomized controlled trials (RCTs) or quasi-RCTs comparing any treatment method for management of NGB in patients with PD were included. The titles and abstracts of all identified studies were evaluated independently by two investigators. Once all of the potential related articles were retrieved, each author separately evaluated the full text of each article and the quality of the methodology of the selected studies using the Cochrane appraisal risk of bias checklist and then the data about the patient's outcomes was extracted. We registered the title in Joanna Briggs Institute (JBI) that is available in http://joannabriggs.org/research/registered_titles.aspx. Results: We included 41 RCTs or quasi-RCTs or three observational study with a total of 1063 patients that evaluated pharmacological, neurosurgical, botulinum toxin, electrical neuromodulation, and behavioral therapy effects on NGB. Among the included studies only solifenacin succinate double-blind, randomized, placebocontrolled study was assessed as low risk of bias, and treatment led to an improvement in urinary incontinence. Conclusions: Although several interventions are available for treatment NGB in patients with PD, at present there is little or no evidence that treatment improves patient outcomes in this population. Additional large, well designed, randomized studies with improved methodology and reporting focused on patient-centered outcomes are needed.

Site-Specific Neuromodulation of Detrusor and External Urethral Sphincter by Epidural Spinal Cord Stimulation

“…To date several neuroprosthetic arrays have been proposed (Borton et al, 2014 ; Hahnewald et al, 2016 ; Minev et al, 2015 ; Bareket et al, 2017 ); there are several existing design solutions (i.e., by Medtronic, Boston Scientific), including LUT spinal implants. Application of these spinal neuroprostheses is non restricted to SCI and may be suitable in patients with other neurological conditions that are accompanied by LUT dysfunction, for example, multiple sclerosis (Phé et al, 2016 ; Peyronnet et al, 2019 ) or Parkinson’s disease (Winge, 2015 ; Hajebrahimi et al, 2019 ).…”

Terapia comportamental associada a neuromodulação no tratamento da bexiga e intestino em indivíduos com Parkinson: um estudo piloto

“…Geralmente, em pacientes com DP, as queixas urinárias primárias incluem urgência, aumento da frequência, incontinência urinária (IU) e noctúria. Esses sintomas de armazenamento urinário são queixas prevalentes de 57-83% dos pacientes com DP 6 .…”

“…A International Continence Society (ICS) define como bexiga hiperativa um conjunto desses sintomas de armazenamento, e quando há uma condição neurológica relevante, a condição é chamada de bexiga neurogênica e é investigada por observação urodinâmica. 6 Os estudos urodinâmicos demonstram capacidade reduzida da bexiga e hiperatividade do detrusor (HD) em 43-93% dos pacientes com DP 7 . No que diz respeito às queixas intestinais, a constipação apresenta-se como sintoma gastrointestinal mais comum na DP, com uma prevalência estimada em aproximadamente 50%.…”

Stem Cell Therapy for Neurogenic Bladder Dysfunction in Rodent Models: A Systematic Review

“…After spinal cord injury (SCI), 70%-84% of patients confront with some degree of bladder dysfunction [3]. NGB has a tremendous effect on the quality of life [4]. In addition to physical and clinical aspects, the signs associated with urinary incontinence can negatively impact a patient's quality of life [5].…”

“…Different strategies including conservative methods (lifestyle changes, bladder retraining, pelvic floor muscle training), pharmacological (anticholinergics, β-adrenoceptor agonists) and nonpharmacological approaches (electrical stimulation, clean intermittent catheterization, and indwelling catheters), as well as surgical interventions (augmentation cystoplasty), have been developed for the management of NGB. However, improvement in voiding dysfunction is not been fully achieved and also was accompanied by several side effects [ 4 , 6 - 10 ]. Based on the results from previous experiments, stem cell (SC) transplantation is used in the management of neuro-urological diseases accompanied by promising outcomes [ 11 ].…”