There is a surprising dearth of information covering the prevalence of urinary symptoms in the parkinsonian population at large.
Murnaghan22 specifically investigated the presence of urological symptoms in 29 PD patients in the pre-
levodopa era, who had been selected to undergo basal ganglia surgery. Eleven (38%) had urological symptoms. Porter and Bors25 investigated a similar group of 62 patients being considered for basal ganglia surgery. Forty-four patients (71%) had urinary symptoms, but the group was primarily male. These figures have a selection bias. It is likely that older and feeble individuals were excluded.
Singer et al.33 reported on a group of consecutive par-kinsonian male patients attending a movement disorders clinic and compared the prevalence of autonomic symptoms with a group of healthy elderly controls. They found that the prevalence of urinary urgency (46%) and sensation of incomplete bladder emptying (42%) was significantly higher than in controls (3% and 16% respectively).
Sakakibara et al.29 studied 115 PD patients (52 men and 63 women) and compared them to controls. All urinary symptoms were significantly higher in PD. Urgency (42% women, 54% men); daytime frequency (28% women, 16% men); nighttime frequency (53% women, 63%men); urge incontinence (25% women, 28% men); retardation in initiating urination (44% men); prolonga tion/poor stream (70% men); straining upon urination (28% women).
Lemack et al.17 selected 80 men and 39 women with mild to moderate PD (Hoehn and Yahr lower than stage 3) and performed a questionnaire-based assessment using the American Urological Association Symptom Index (AUASI) in men and the Urogenital Distress Inventory-6 (UDI-6) in women. Men scored higher than age-matched controls with similar values to those of men with symptomatic benign prostatic hyperplasia. Results were less clear with PD women, who scored higher than non-age-matched volunteers but lower than an age-matched group of women (unaffected neurologically) presenting for uro-logical evaluation.
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