Bladder dysfunction in patients with stages I—III of Parkinson’s disease

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OBJECTIVE

To evaluate bladder dysfunction (BD) and its relationship with Parkinson’s disease (PD) symptoms and dopaminergic therapy.

MATERIAL AND METHODS

One hundred and thirteen patients with PD of I—III H&Y stages were examined using the following scales: IPSS, including irritative and obstructive symptom indices, UPDRS I—IV, Sch&En, PDQ-39, BDI, STAI, PFS-16, GDSS, GSRS, MMSE, FAB and NMSQ.

RESULTS

Most of the patients (89.4%) had BD according to IPSS (Me=6.0 [3.0—13.0]), all of them showed irritative disorders, which were combined with obstructive ones in 61%. BD did not depend on sex, stage and duration of PD. IPSS scores correlated with age (rS=0.307), Sch&En (rS=–0.210) and PDQ-39 (rS=0.460), total UPDRS score (rS=0.296) and subscales I—IV scores, postural stability, and non-motor disorders (depression, anxiety, fatigue, frontal dysfunction, and gastrointestinal and orthostatic symptoms). No significant effect of dopaminergic therapy on BD severity was found. BD occurrence predictors according to regression analysis are (R²=0.420) BDI, FAB and male sex. An analysis of obstructive symptoms index in the general group and separately for women showed many correlations with motor PD symptoms (hypokinesia, rigidity, and off-periods) meanwhile the irritative index had practically no such correlations.

CONCLUSIONS

BD is present in the majority of PD patients and significantly reduces the quality of life already in the early stages of PD; BD predictors are depression, frontal dysfunction and male sex. Both obstructive and evacuation dysfunctions are detected in men and women. The obstructive dysfunction relations with a wide range of motor and non-motor PD symptoms indicate that neurodegenerative process is involved in its development.

Keywords:

Parkinson’s disease

non-motor disorders

autonomic disorders

bladder dysfunction

irritative and obstructive symptoms

Authors:

Pilipovich A.A.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-7416-9050

Vorob’eva O.V.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-5070-926X

Makarov S.A.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-5663-6628

Received:

07.07.2024

Accepted:

12.07.2024

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