Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, University of Louisville School of Medicine, Louisville, KY, USA.
Division of Movement disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA.
J Parkinsons Dis. 2021;11(2):857-864. doi: 10.3233/JPD-202491.
Urinary dysfunction and constipation, manifestations of pelvic floor dysfunction are common sources of disability and impaired quality of life in women with Parkinson's disease (PD).
We sought to evaluate the pelvic floor health amongst women with PD and their reporting of bladder and bowel symptoms.
We surveyed women with PD and age-matched controls about pelvic floor health using validated questionnaires. All participants completed the Pelvic Floor Disability Index (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Patient-Reported Outcomes Measurement Information System (PROMIS) short form version 2.0 Cognitive Function 8a. Additionally, PD patients underwent the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scale and the Montreal Cognition Assessment (MoCA).
Women with PD (n = 59; age, 70.4±8.6 years, PROMIS cognitive score, 52.0±7.8) self-reported urinary symptoms to a greater extent than controls (n = 59; age, 70.2±8.7 years, PROMIS cognitive score, 51.0±10) (68% vs 43%, p < 0.01). The difference was mirrored by higher (worse) scores on both PFDI-20 (35.4 vs 15.6; p = 0.01) and PFIQ-7 (4.8 vs 0; p < 0.01) for PD women compared to controls. Only 63% of all participants with self-reported pelvic floor symptoms had previously reported these symptoms to a health care provider. There was no difference in utilization of specialty care between the two groups (30% vs 46%, p = 0.2).
Pelvic floor dysfunction, more common amongst women with PD, is underreported and undertreated. Our study identifies a key gap in care of women with PD.
尿功能障碍和便秘是女性帕金森病(PD)患者常见的盆底功能障碍表现,也是导致残疾和生活质量受损的主要原因。
我们旨在评估 PD 女性的盆底健康状况及其膀胱和肠道症状的报告情况。
我们使用经过验证的问卷对 PD 女性和年龄匹配的对照组进行了盆底健康调查。所有参与者均完成了盆底功能障碍指数(PFDI-20)、盆底影响问卷(PFIQ-7)和患者报告的结局测量信息系统(PROMIS)简表 2.0 版认知功能 8a 量表。此外,PD 患者还接受了运动障碍协会统一帕金森病评定量表(MDS-UPDRS)和蒙特利尔认知评估(MoCA)。
PD 女性(n=59;年龄 70.4±8.6 岁,PROMIS 认知评分 52.0±7.8)自我报告的尿症状比对照组(n=59;年龄 70.2±8.7 岁,PROMIS 认知评分 51.0±10)更严重(68%比 43%,p<0.01)。PFDI-20(35.4 比 15.6;p=0.01)和 PFIQ-7(4.8 比 0;p<0.01)评分更高(更差),这反映了 PD 女性的情况比对照组更差。只有 63%有盆底症状自我报告的参与者曾向医疗保健提供者报告过这些症状。两组之间的专科护理利用率没有差异(30%比 46%,p=0.2)。
PD 女性更常见的盆底功能障碍,报告和治疗不足。我们的研究发现了 PD 女性护理方面的一个主要差距。