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Abstract

Background Urinary dysfunction is common in Parkinson's disease (PD); however, 
little is known about urinary dysfunction in early and untreated PD patients. 
Methods Fifty consecutive untreated PD patients (mean age, 66.7; mean disease 
duration, 23.6 months; and mean Hoehn & Yahr scale, 1.9) were 
recruited; those with other conditions that might have influenced urinary 
function were excluded. Patients were evaluated using a urinary questionnaire 
and urodynamic studies. Results Sixty-four per cent complained of urinary 
symptoms (storage, 64.0%; voiding, 28.0%). Urodynamic studies showed abnormal 
findings in the storage phase in 84%, with detrusor overactivity (DO) and 
increased bladder sensation without DO in 58.0% and 12.0% of patients, 
respectively. In the voiding phase, detrusor underactivity, impaired urethral 
relaxation such as detrusor sphincter dyssynergia, and bladder outlet 
obstruction were present in 50.0%, 8.0% and 16% of patients, respectively. In 
patients with both storage and voiding phase abnormalities, DO+detrusor 
underactivity was the most common finding. Few patients experienced urge 
incontinence and/or quality-of-life impairment owing to urinary dysfunction; 
none had low-compliance bladder or abnormal anal-sphincter motor unit 
potential. These urinary symptoms and urodynamic findings were not correlated 
with gender, disease severity or motor symptom type. Conclusion Urinary 
dysfunction, manifested primarily as storage disorders with subclinical 
voiding disorders and normal anal-sphincter electromyography, occurs in early 
and untreated PD patients. In cases with severe voiding disorder and/or 
abnormal anal-sphincter electromyography, other diagnoses should be 
considered.

http://www.ncbi.nlm.nih.gov/pubmed/21670077

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