Sammour Zein M, Gomes Cristiano M, Barbosa Egberto R, Lopes Roberto I, Sallem Flávio S, Trigo-Rocha Flavio E, Bruschini Homero, Srougi Miguel
Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
Neurourol Urodyn. 2009;28(6):510-5. doi: 10.1002/nau.20681.
We assessed the lower urinary tract symptoms (LUTS) of patients with Parkinson's disease (PD) and their association with different clinical parameters.
We prospectively evaluated 110 patients (84 men), with a mean age of 61.8 +/- 9.6 years. Mean duration of the disease was 12.3 +/- 7.2 years. Neurological impairment was assessed by the Hoehn-Yahr and the Unified Parkinson Disease Rating scales. LUTS were assessed by the International Continence Society questionnaire. We evaluated the impact of age, PD duration, neurological impairment, gender, and use of anti-Parkinsonian drugs on the voiding function.
On multivariate analysis, voiding dysfunction increased with the neurological impairment, but not with patient's age or disease duration. Quality of life (QOL) was affected by the severity of LUTS, and the symptoms with the worst impact were frequency and nocturia. Sixty-three (57.2%) patients were symptomatic. They did not differ with the asymptomatic as to age and disease duration, but had more severe neurological impairment. No impact on LUTS was associated with the use of levodopa, anticholinergics, and dopamine receptor agonists. Men and women were similarly affected by urinary symptoms.
The severity of the neurological disease is the only predictive factor for the occurrence of voiding dysfunction, which affects men and women alike.
我们评估了帕金森病(PD)患者的下尿路症状(LUTS)及其与不同临床参数的关联。
我们前瞻性地评估了110例患者(84例男性),平均年龄为61.8±9.6岁。疾病平均病程为12.3±7.2年。通过Hoehn-Yahr量表和统一帕金森病评定量表评估神经功能损害。通过国际尿控协会问卷评估LUTS。我们评估了年龄、PD病程、神经功能损害、性别以及使用抗帕金森药物对排尿功能的影响。
多因素分析显示,排尿功能障碍随神经功能损害加重而增加,但与患者年龄或疾病病程无关。生活质量(QOL)受LUTS严重程度影响,影响最严重的症状是尿频和夜尿。63例(57.2%)患者有症状。他们在年龄和疾病病程方面与无症状患者无差异,但神经功能损害更严重。左旋多巴、抗胆碱能药物和多巴胺受体激动剂的使用与LUTS无关。男性和女性受泌尿系统症状的影响相似。
神经疾病的严重程度是排尿功能障碍发生的唯一预测因素,男性和女性受其影响程度相同。