Questions or comments about this article may be directed to Joanne P. Robinson, PhD RN GCNS-BC FAAN, at
J Neurosci Nurs. 2013 Dec;45(6):382-92; quiz E1-2. doi: 10.1097/JNN.0b013e3182a3cf67.
The aim of this study was to examine the prevalence, presentation, and predictors of lower urinary tract symptoms (LUTS) in men with idiopathic Parkinson disease (PD).
Guided by the Theory of Unpleasant Symptoms, this retrospective exploratory study used data abstracted from admission clinical records of 271 male patients with idiopathic PD enrolled in a movement disorders clinic at a large metropolitan Veterans Affairs Medical Center in the eastern region of the United States. Data from the admission questionnaire, Unified Parkinson's Disease Rating Scale, and Mini Mental State Examination were abstracted by trained research assistants. Interrater reliability for the abstraction process was 0.99 in a randomly selected 10% sample of records. Descriptive statistics were used to determine the prevalence of LUTS. Logistic regression was used to determine LUTS risk factors and predictors.
At least one LUTS was reported by 40.2% of participants. Incontinence was the most prevalent symptom, affecting almost 25% of participants, followed by nocturia (14.8%) and frequency (13.7%). Of the 10 identified risk factors for LUTS, four significant predictors were discovered: number of non-PD medications (p < .05), PD duration (p < .05), number of comorbidities (p < .05), and history of a hernia diagnosis (p < .05).
Assessment for LUTS should be a component of every evaluation of a patient with PD. Our findings offer a preliminary profile of the male PD patient with LUTS, which is an important step toward effective screening, detection, and access to care and treatment. Next steps in research include further work to identify predictors of LUTS in both male and female PD populations, explore patient perspectives, begin trials of interventions for LUTS in the PD population, and analyze the economic impact.
本研究旨在探讨特发性帕金森病（PD）男性患者下尿路症状（LUTS）的患病率、表现和预测因素。
本回顾性探索性研究以不愉快症状理论为指导，使用美国东部一家大型大都市退伍军人事务医疗中心运动障碍诊所 271 名特发性 PD 男性患者入院临床记录中的数据。训练有素的研究助理从入院问卷、统一帕金森病评定量表和简易精神状态检查中提取数据。记录中随机抽取 10%的样本进行评估，评估过程的组内相关系数为 0.99。采用描述性统计确定 LUTS 的患病率。采用逻辑回归确定 LUTS 的危险因素和预测因素。
至少有 1 种 LUTS 的报告率为 40.2%。尿失禁是最常见的症状，几乎影响了 25%的参与者，其次是夜尿症（14.8%）和尿频（13.7%）。在 10 种 LUTS 风险因素中，发现了 4 个显著的预测因素：非 PD 药物数量（p <.05）、PD 病程（p <.05）、合并症数量（p <.05）和疝气诊断史（p <.05）。
对 LUTS 的评估应成为每位 PD 患者评估的一部分。我们的发现为患有 LUTS 的男性 PD 患者提供了初步的概况，这是有效筛查、检测以及获得护理和治疗的重要一步。下一步的研究包括进一步工作，以确定男性和女性 PD 人群中 LUTS 的预测因素，探索患者的观点，开始针对 PD 人群中 LUTS 的干预措施试验，并分析其经济影响。
