Urinary Problems in Idiopathic Parkinson's Disease and Multiple System Atrophy

J Korean Neurol Assoc > Volume 14(3); 1996 > Article

Journal of the Korean Neurological Association 1996;14(3): 738-745.

특발성 파킨슨씨병과 다계통위축증환자들의 배뇨장애에 대한 고찰

김용덕, 이상복, 김원찬, 이명식

연세대학교 의과대학 영동세브란스병원 신경과

Urinary Problems in Idiopathic Parkinson's Disease and Multiple System Atrophy

Yong duk Kim, M.D., Sang Bock Lee, M.D., Won Chan Kim, M.D., Myung Sik Lee, M.D.

Department of neurology, Yongdong Severance Hospital Yonsei University College of Medicine

Abstract

Previous studies showed that 37-71% of the patients with idiopathic Parkinson's disease (IPD) or parkinsonism of other causes had urinary problems. There are several possible reasons for such wide range of frequency of urinary problems in Parkinson's disease or parkinsonism; (1) They used different questionnaires on the urinary problems; (2) they did not try to differentiate the patients with idiopathic Parkinson's disease and those with multiple system atrophy (MSA) , in which condition severe urinary problems occur frequently early in the clinical course or even before the onset of parkinsonian symptoms. However, exact nature of urinary problems in MSA and IPD has never been compared. Using Boyarsky score, we compared the frequency and severity of urinary symptoms between 32 patients with IPD and 28 patients with probable MSA. All except one with MSA (96.5%) had urinary symptoms. Although 24 of the 32 with IPD (75%) also had urinary problems, the severity was milder than those with MSA. In 8 with MSA, urinary symptoms preceeded the onset of parkinsonian symptoms. No one with IPD developed urinary symptoms before the onset of parkinsonian symptoms. Seven out of the 28 patients with MSA voided more than 8 times during the day, 10 woke up more than 2 times to void during sleep, 20 wet their clothes more than 2 times per a day. However no one with IPD had such severe urinary problems. Careful history taking about the urinary had such severe urinary problems. Careful history taking and MSA problems seems to be a helpful way in differentiating IPD and MSA.