Aranda B
Service de Rééducation, Centre Hospitalier, Gonesse, Courbevoie.
Rev Neurol (Paris). 1993;149(8-9):476-80.
Urinary bladder disorders often occur, sometimes very early, during the course of Parkinson's disease. Careful analysis of symptoms including clinical examination, urodynamic studies and radiographic data is essential before choosing a treatment, especially before prostatic surgery. We studied 41 parkinsonian patients. Bladder hyperreflexia occurred in 88% and bladder hyporeflexia in only 12%. In 16 patients, we tested bladder activity after a subcutaneous injection of apomorphine. All patients with hyperreflexia were improved whereas hyporeflexic patients remained unchanged. These findings and data from the literature suggest that in Parkinson's disease detrusor hyperreflexia is the consequence of dopamine nigrostriatal depletion. The physiopathology of bladder hyporeflexia is less understood. The practical care of parkinsonians with urinary disorders is detailed.
膀胱功能障碍在帕金森病病程中经常出现，有时出现得很早。在选择治疗方法之前，尤其是在前列腺手术之前，仔细分析包括临床检查、尿动力学研究和影像学数据在内的症状至关重要。我们研究了41例帕金森病患者。膀胱反射亢进发生率为88%，膀胱反射减退仅为12%。我们对16例患者皮下注射阿扑吗啡后测试膀胱功能。所有反射亢进患者均有改善，而反射减退患者则无变化。这些发现以及文献数据表明，在帕金森病中逼尿肌反射亢进是黑质纹状体多巴胺耗竭的结果。膀胱反射减退的生理病理学尚不太清楚。文中详细介绍了帕金森病患者泌尿系统疾病的实际护理方法。
