Urological dysfunction

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Symptoms of urinary dysfunction occur frequently in patients with Parkinson's disease (PD), particularly men. Irritative symptoms, such as frequency, urgency, and urge incontinence, are reported in 57-83% of patients with PD. Obstructive symptoms, such as hesitancy and weak urinary stream, may be present in 17-36% of individuals. The appearance of urinary symptoms may follow the appearance of motor symptoms by a few years. Several mechanisms, such as detrusor hyperre flexia, detrusor are flexia, coexistent obstructive uropathies, and dysfunction of infravesical mechanisms, can be responsible for the urinary dysfunction in patients with PD. Detrusor hyperre flexia is the urodynamic correlate of irritative urinary symptoms. Detrusor are flexia is uncommon in PD and, when present, is usually secondary to the use of anticholinergic medications. Coexistent obstructive uropathies may complicate the clinical picture in patients with PD and produce both obstructive and irritative symptoms. Urinary dysfunction in PD also may be the result of dysfunctional infravesical mechanisms such as sphincter bradykinesia. In terms of pathogenesis, voiding dysfunction in PD is primarily due to the loss of the inhibitory effect that the basal ganglia exert on the pontine micturition center. This inhibitory effect likely is mediated by D1 dopamine receptors and results in a "quiet bladder" during the filling phase. In terms of treatment, the irritative symptoms often can be treated successfully with anticholinergic drugs; however, for refractory overactive bladder, intravesical botulinum toxin injections or deep brain stimulation surgery may be required. If the symptoms are obstructive in nature, bladder catheterization and sometimes urological surgery may be necessary.

Original languageEnglish (US)
Title of host publicationParkinson's Disease and Nonmotor Dysfunction
Subtitle of host publicationSecond Edition
PublisherHumana Press Inc.
Pages187-200
Number of pages14
ISBN (Electronic)9781607614296
ISBN (Print)9781607614289
DOIs
StatePublished - Jan 1 2013

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Parkinson Disease
Cholinergic Antagonists
Urinary Bladder
Urge Urinary Incontinence
Overactive Urinary Bladder
Dopamine D1 Receptors
Hypokinesia
Deep Brain Stimulation
Botulinum Toxins
Urination
Urodynamics
Basal Ganglia
Catheterization
Injections
Pharmaceutical Preparations

Keywords

  • Anticholinergics
  • Basal ganglia
  • Biofeedback
  • Botulinum toxin
  • Cystometrogram
  • Cystostomy
  • Darifenacin
  • Deep brain stimulation
  • Detrusor
  • Detrusor areflexia
  • Detrusor hyperreflexia
  • Detrusor re flex
  • Dopamine
  • Dopamine agonists
  • Dysfunctional infravesical mechanisms
  • Erectile dysfunction
  • Flavoxate
  • Hoehn and Yahr
  • Hyoscyamine
  • Intermittent catheterization
  • Involuntary detrusor contraction
  • Irritative
  • Levodopa
  • Lower urinary tract symptoms
  • Mean maximum cystometric capacity
  • Multiple system atrophy
  • Myogenic are flexia
  • Neurogenic bladder
  • Obstructive
  • Obstructive uropathy
  • Onuf's nucleus
  • Oxybutynin
  • Oxybutynin LA
  • Parkinson's disease
  • Percutaneous posterior tibial nerve stimulation
  • Periaqueductal gray matter
  • Pontine micturition center
  • Pontine storage center
  • Positron emission tomography
  • Postvoid residual volume
  • Propantheline bromide
  • Pseudodyssynergia
  • Repetitive transcranial magnetic stimulation
  • Solifenacin
  • Sphincter bradykinesia
  • Sphincter EMG
  • Sphincter tremor
  • Subthalamic nucleus
  • Thalamotomy
  • Tolterodine
  • Tolterodine LA
  • Transurethral prostatectomy
  • Trospium chloride
  • Trospium XR
  • Urge incontinence
  • Urge incontinence
  • Urgency
  • Urinary dysfunction
  • Urinary urgency
  • Urodynamic studies
  • Vesicosphincter dyssynergia
  • Voiding dysfunction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Moore, H. P., & Singer, C. (2013). Urological dysfunction. In Parkinson's Disease and Nonmotor Dysfunction: Second Edition (pp. 187-200). Humana Press Inc.. https://doi.org/10.1007/978-1-60761-429-6_12

Urological dysfunction. / Moore, Henry P; Singer, Carlos.

Parkinson's Disease and Nonmotor Dysfunction: Second Edition. Humana Press Inc., 2013. p. 187-200.

Research output: Chapter in Book/Report/Conference proceedingChapter

Moore, HP & Singer, C 2013, Urological dysfunction. in Parkinson's Disease and Nonmotor Dysfunction: Second Edition. Humana Press Inc., pp. 187-200. https://doi.org/10.1007/978-1-60761-429-6_12
Moore HP, Singer C. Urological dysfunction. In Parkinson's Disease and Nonmotor Dysfunction: Second Edition. Humana Press Inc. 2013. p. 187-200 https://doi.org/10.1007/978-1-60761-429-6_12
Moore, Henry P ; Singer, Carlos. / Urological dysfunction. Parkinson's Disease and Nonmotor Dysfunction: Second Edition. Humana Press Inc., 2013. pp. 187-200
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N2 - Symptoms of urinary dysfunction occur frequently in patients with Parkinson's disease (PD), particularly men. Irritative symptoms, such as frequency, urgency, and urge incontinence, are reported in 57-83% of patients with PD. Obstructive symptoms, such as hesitancy and weak urinary stream, may be present in 17-36% of individuals. The appearance of urinary symptoms may follow the appearance of motor symptoms by a few years. Several mechanisms, such as detrusor hyperre flexia, detrusor are flexia, coexistent obstructive uropathies, and dysfunction of infravesical mechanisms, can be responsible for the urinary dysfunction in patients with PD. Detrusor hyperre flexia is the urodynamic correlate of irritative urinary symptoms. Detrusor are flexia is uncommon in PD and, when present, is usually secondary to the use of anticholinergic medications. Coexistent obstructive uropathies may complicate the clinical picture in patients with PD and produce both obstructive and irritative symptoms. Urinary dysfunction in PD also may be the result of dysfunctional infravesical mechanisms such as sphincter bradykinesia. In terms of pathogenesis, voiding dysfunction in PD is primarily due to the loss of the inhibitory effect that the basal ganglia exert on the pontine micturition center. This inhibitory effect likely is mediated by D1 dopamine receptors and results in a "quiet bladder" during the filling phase. In terms of treatment, the irritative symptoms often can be treated successfully with anticholinergic drugs; however, for refractory overactive bladder, intravesical botulinum toxin injections or deep brain stimulation surgery may be required. If the symptoms are obstructive in nature, bladder catheterization and sometimes urological surgery may be necessary.

AB - Symptoms of urinary dysfunction occur frequently in patients with Parkinson's disease (PD), particularly men. Irritative symptoms, such as frequency, urgency, and urge incontinence, are reported in 57-83% of patients with PD. Obstructive symptoms, such as hesitancy and weak urinary stream, may be present in 17-36% of individuals. The appearance of urinary symptoms may follow the appearance of motor symptoms by a few years. Several mechanisms, such as detrusor hyperre flexia, detrusor are flexia, coexistent obstructive uropathies, and dysfunction of infravesical mechanisms, can be responsible for the urinary dysfunction in patients with PD. Detrusor hyperre flexia is the urodynamic correlate of irritative urinary symptoms. Detrusor are flexia is uncommon in PD and, when present, is usually secondary to the use of anticholinergic medications. Coexistent obstructive uropathies may complicate the clinical picture in patients with PD and produce both obstructive and irritative symptoms. Urinary dysfunction in PD also may be the result of dysfunctional infravesical mechanisms such as sphincter bradykinesia. In terms of pathogenesis, voiding dysfunction in PD is primarily due to the loss of the inhibitory effect that the basal ganglia exert on the pontine micturition center. This inhibitory effect likely is mediated by D1 dopamine receptors and results in a "quiet bladder" during the filling phase. In terms of treatment, the irritative symptoms often can be treated successfully with anticholinergic drugs; however, for refractory overactive bladder, intravesical botulinum toxin injections or deep brain stimulation surgery may be required. If the symptoms are obstructive in nature, bladder catheterization and sometimes urological surgery may be necessary.

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KW - Basal ganglia

KW - Biofeedback

KW - Botulinum toxin

KW - Cystometrogram

KW - Cystostomy

KW - Darifenacin

KW - Deep brain stimulation

KW - Detrusor

KW - Detrusor areflexia

KW - Detrusor hyperreflexia

KW - Detrusor re flex

KW - Dopamine

KW - Dopamine agonists

KW - Dysfunctional infravesical mechanisms

KW - Erectile dysfunction

KW - Flavoxate

KW - Hoehn and Yahr

KW - Hyoscyamine

KW - Intermittent catheterization

KW - Involuntary detrusor contraction

KW - Irritative

KW - Levodopa

KW - Lower urinary tract symptoms

KW - Mean maximum cystometric capacity

KW - Multiple system atrophy

KW - Myogenic are flexia

KW - Neurogenic bladder

KW - Obstructive

KW - Obstructive uropathy

KW - Onuf's nucleus

KW - Oxybutynin

KW - Oxybutynin LA

KW - Parkinson's disease

KW - Percutaneous posterior tibial nerve stimulation

KW - Periaqueductal gray matter

KW - Pontine micturition center

KW - Pontine storage center

KW - Positron emission tomography

KW - Postvoid residual volume

KW - Propantheline bromide

KW - Pseudodyssynergia

KW - Repetitive transcranial magnetic stimulation

KW - Solifenacin

KW - Sphincter bradykinesia

KW - Sphincter EMG

KW - Sphincter tremor

KW - Subthalamic nucleus

KW - Thalamotomy

KW - Tolterodine

KW - Tolterodine LA

KW - Transurethral prostatectomy

KW - Trospium chloride

KW - Trospium XR

KW - Urge incontinence

KW - Urge incontinence

KW - Urgency

KW - Urinary dysfunction

KW - Urinary urgency

KW - Urodynamic studies

KW - Vesicosphincter dyssynergia

KW - Voiding dysfunction

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