Badri Anand V, Purohit Rajveer S, Skenazy Jason, Weiss Jeffrey P, Blaivas Jerry G
State University of New York Downstate Medical Center, Brooklyn, NY, USA,
Curr Urol Rep. 2014 Sep;15(9):435. doi: 10.1007/s11934-014-0435-0.
To critically review recent literature on lower urinary tract symptoms (LUTS) in patients with Parkinson's Disease.A literature search was conducted using the keywords LUTS, urinary symptoms, non-motor, and Parkinson's disease (PD) via the PubMed/Medline search engine. In the literature, we critically examined lower urinary symptoms in Parkinson's patients by analyzing prevalence, pathogenesis, urinary manifestations, pharmacologic trials and interventions, and prior review articles. The data collected ranged from 1986 to the present with an emphasis placed on recent publications.The literature regards LUTS in PD as a major comorbidity, especially with respect to a patient's quality of life. Parkinson's patients experience both storage and voiding difficulties. Storage symptoms, specifically overactive bladder, are markedly worse in patients with PD than in the general population. Surgical management of prostatic obstruction in PD can improve urinary symptoms. Multiple management options exist to alleviate storage LUTS in patients with PD, ranging from behavioral modification to surgery, and vary in efficacy.Lower urinary tract dysfunction in PD may be debilitating. Quality of life can be improved with a multi-pronged diagnosis-specific approach to treatment that takes into consideration a patient's ability to comply with treatment. A stepwise algorithm is presented and may be utilized by clinicians in managing LUTS in Parkinson's patients.
批判性地回顾帕金森病患者下尿路症状（LUTS）的近期文献。通过PubMed/Medline搜索引擎，使用关键词LUTS、泌尿系统症状、非运动症状和帕金森病（PD）进行文献检索。在文献中，我们通过分析患病率、发病机制、泌尿系统表现、药物试验和干预措施以及先前的综述文章，对帕金森病患者的下尿路症状进行了批判性研究。收集的数据范围从1986年至今，重点关注近期发表的文章。文献认为帕金森病中的LUTS是一种主要的合并症，特别是在患者生活质量方面影响较大。帕金森病患者存在储尿和排尿困难。储尿症状，尤其是膀胱过度活动症，在帕金森病患者中比在普通人群中明显更严重。帕金森病患者前列腺梗阻的手术治疗可改善泌尿系统症状。存在多种管理方案来缓解帕金森病患者的储尿期LUTS，从行为改变到手术，疗效各不相同。帕金森病患者的下尿路功能障碍可能使人衰弱。通过考虑患者依从治疗的能力，采用多方面针对特定诊断的治疗方法可以改善生活质量。本文提出了一种逐步算法，临床医生在管理帕金森病患者的LUTS时可加以利用。
