What is the role of Parkinson disease in the etiology of neurogenic bladder?

Updated: Dec 06, 2018
  • Author: Bradley C Gill, MD, MS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

This is a degenerative disorder of pigmented neurons of substantia nigra. It results in dopamine deficiency and increased cholinergic activity in the corpus striatum. Symptoms specific to the urinary bladder include urinary frequency, urinary urgency, nocturia, and urge incontinence.

Typical urodynamic findings for Parkinson disease are most consistent with detrusor hyperreflexia and urethral sphincter bradykinesia. The striated urethral sphincter often demonstrates poorly sustained contraction.

As with other supraspinal lesions, the treatment for Parkinson disease is to facilitate bladder filling and promote urinary storage with anticholinergic agents.

In men with Parkinson disease who exhibit symptoms of bladder outlet obstruction (BOO) due to benign prostatic hypertrophy (BPH), the diagnosis of BOO should be confirmed by multichannel urodynamic studies. The most common cause of postprostatectomy incontinence in the patient with Parkinson disease is detrusor hyperreflexia. If transurethral resection of the prostate (TURP) is performed without urodynamic confirmation of obstruction, the patient may become totally incontinent after the TURP procedure.


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