Lower Urinary Tract Symptoms in Nigerian Men With Parkinsons Disease

Abstract

Introduction: Parkinsons disease (PD) is the commonest age related motoric neurodegenerative disease. It results from the destruction of dopaminergic cell in the substantial nigra in the midbrain. In addition to the typical motor Parkinsonism symptoms, non -motor manifestations affect multiple organs including the lower urinary tract and contribute to worsening the overall quality of life. The objective of this study is to highlight the bother from lower urinary tract symptoms in patients with PD and determine the relationship between the lower urinary symptoms and severity of PD. Materials and Methods: This is a descriptive cross-sectional study in patients with clinically diagnosed PD that were managed by the Neurology Unit, Neurology Unit, Department of Medicine University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria. They all filled the International Prostate Symptom Score and Quality of Life form. The severity of PD in each patient was assessed using Unified Parkinsons Disease Rating Scale (UPDRS). The data obtained was analyzed using SPSS Version 20. Results: There were 22 patients aged between 25-87years with a mean age of 59.36 ±15.58years. Nocturia (90.90%), frequency (59.10%) and urgency (59.10%) were the commonest LUTS, while straining was the least frequent (22.70 %). Majority had mild (59.09%)and moderate (27.27%) symptoms. There was a strong association between total IPSSand QoL scores that was statistically significant (p<0.0001 r= +0.859). The degree of bother from LUTS, evaluated with the IPSS questionnaire was associated with worsening of PD symptoms assessed with UPDRS (p=0.012). There was a moderate positive correlation between the severity of PD and the degree of bother from LUTS in PD patients (r=+0.527) Conclusions: Irritative symptoms are very common in Parkinsons disease, with nocturia the commonest. There was a moderate positive correlation between the severity of PD and the degree of bother from LUTS. The IPSS questionnaire could be used in evaluating urinary dysfunction in PD patients in both genders.