Questionnaire-based assessment of bladder dysfunction in patients with mild to moderate Parkinson's disease

Objectives. To assess the lower urinary tract symptoms (LUTS) in men and wo men with mild to moderate Parkinson's disease (PD) using validated symptom questionnaires. Methods. Eighty men and 39 women with mild to moderate PD (Hoehn and Yahr s core less than 3) were mailed LUTS questionnaires to complete and return. M en received the American Urological Association Symptom Index and women rec eived the Urogenital Distress Inventory-6. Patients not responding by mail were called and asked to complete the survey over the telephone. Control po pulations of both symptomatic and asymptomatic men and women (without PD) w ere identified for comparison. Results. The overall response rate was 78%. Men with early-stage PD had hig her American Urological Association Symptom Index scores than age-matched c ontrols (total score of 12.0 versus 7.7, P <0.05) and scores similar to tho se reported for men with symptomatic benign prostatic hyperplasia (12.5). S pecific items noted to be higher among the men with PD included questions r egarding frequency and urgency. Women with PD had higher scores on the Urog enital Distress Inventory-6 than non-age-matched controls (total score of 4 .8 versus 2.1, P <0.05), but lower scores than an age-matched group of neur ologically intact women presenting for urologic evaluation of LUTS (6.9, P <0.05). Conclusions. On the basis of the responses to the validated symptom indexes , the development of LUTS appears to occur at an earlier stage of PD than w as once appreciated. Prompt evaluation and treatment of patients with lower urinary tract complaints in the setting of PD may identify bladder dysfunc tion at an earlier, more treatable stage. UROLOGY 56: 250-254, 2000. (C) 20 00, Elsevier Science Inc.