Vurture Gregory, Peyronnet Benoit, Palma Jose-Alberto, Sussman Rachael D, Malacarne Dominique R, Feigin Andrew, Palmerola Ricardo, Rosenblum Nirit, Frucht Steven, Kaufmann Horacio, Nitti Victor W, Brucker Benjamin M
Department of Urology, New York University School of Medicine, New York, NY, USA.
Department of Urology, University of Rennes, Rennes, France.
Int Neurourol J. 2019 Sep;23(3):211-218. doi: 10.5213/inj.1938086.043. Epub 2019 Sep 30.
To assess the urodynamic findings in patients with Parkinson disease (PD) with overactive bladder symptoms.
We performed a retrospective chart review of all PD patients who were seen in an outpatient clinic for lower urinary tract symptoms (LUTS) between 2010 and 2017 in a single-institution. Only patients who complained of overactive bladder (OAB) symptoms and underwent a video-urodynamic study for these symptoms were included. We excluded patients with neurological disorders other than PD and patients with voiding LUTS but without OAB symptoms.
We included 42 patients (29 men, 13 women, 74.5±8.1 years old). Seven patients (16.7%) had a postvoid residual (PVR) bladder volume >100 mL and only one reported incomplete bladder emptying. Detrusor overactivity (DO) was found in all 42 patients (100%) and was terminal in 19 (45.2%) and phasic in 22 patients (52.4%). Eighteen patients had detrusor underactivity (DU) (42.3%). Later age of PD diagnosis was the only parameter associated with DU (P=0.02). Patients with bladder outlet obstruction (BOO) were younger than patients without BOO (70.1 years vs. 76.5 years, P=0.004), had later first sensation of bladder filling (173.5 mL vs. 120.3 mL, P=0.02) and first involuntary detrusor contraction (226.4 mL vs. 130.4 mL, P=0.009).
DO is almost universal in all patients with PD complaining of OAB symptoms (97.1%). However, a significant percentage of patients also had BOO (36.8%), DU (47%), and increased PVR (16.7%) indicating that neurogenic DO may not be the only cause of OAB symptoms in PD patients.
评估有膀胱过度活动症状的帕金森病（PD）患者的尿动力学检查结果。
我们对2010年至2017年在单一机构门诊因下尿路症状（LUTS）就诊的所有PD患者进行了回顾性病历审查。仅纳入主诉有膀胱过度活动（OAB）症状并因这些症状接受了影像尿动力学检查的患者。我们排除了除PD以外患有神经疾病的患者以及有排尿LUTS但无OAB症状的患者。
我们纳入了42例患者（29例男性，13例女性，年龄74.5±8.1岁）。7例患者（16.7%）排尿后残余（PVR）膀胱容量>100 mL，只有1例报告膀胱排空不完全。42例患者均发现逼尿肌过度活动（DO）（100%），其中终末型19例（45.2%），相型22例（52.4%）。18例患者存在逼尿肌活动低下（DU）（42.3%）。PD诊断时年龄较大是与DU相关的唯一参数（P = 0.02）。有膀胱出口梗阻（BOO）患者比无BOO患者年轻（70.1岁对76.5岁，P = 0.004），膀胱初次充盈感觉出现较晚（173.5 mL对120.3 mL，P = 0.02），首次逼尿肌不自主收缩出现较晚（226.4 mL对130.4 mL，P = 0.009）。
在所有主诉有OAB症状的PD患者中，DO几乎普遍存在（97.1%）。然而，相当比例的患者也有BOO（36.8%）、DU（47%）和PVR增加（16.7%），这表明神经源性DO可能不是PD患者OAB症状的唯一原因。
