Objective: To develop an easy to use toolkit that expedites the work-up and management of lower urinary tract symptoms (LUTS) in people with parkinsonism for healthcare professionals. This is accompanied by a handbook for patients with supporting information and advice on self-care.

Background: LUTS are incredibly common in parkinsonism, affecting quality of life and causing morbidity through falls. LUTS frequently do not respond to dopaminergic therapy and the concepts of management are more based in urological rather than neurological practice

Method: In order to generate a meaningful toolkit to aid Parkinson’s clinicians in managing LUTS, a steering group was created comprising of neurologists, geriatricians, urologists, GPs and specialist nurses. Knowledge to develop the toolkit was gained from a multitude of sources. A systematic review of all literature concerning parkinsonism and LUTS was also undertaken. Focus groups were undertaken with parkinsonism and their carers, to understand the challenges of these symptoms and their experiences of assessment/management

Results: 69 clinicians across the UK and from differing professional backgrounds completed a survey enquiring about baseline knowledge and confidence with this topic, perceived challenges and barriers. Survey results suggested that Parkinson’s clinicians lacked confidence with differentiating urological comorbidities in females (66%), when referral to urology might be appropriate (62%), and lack access to patient self-care/behavioural resources (60%). The literature review highlighted 2653 articles, of which 215 appropriately discussed the assessment/management of LUTS. Evidence specific to parkinsonism was low level, and much practice extrapolated from general urological care

Conclusion: A visual flow chart was produced as the main toolkit component for clinicians. This concerns a) assessment, b) management strategies specific to LUTS type and c) an infographic for interpretating post-void residuals. This is displayed in this presentation and is available through the Parkinson’s UK website. An accompanying handbook for clinicians concerning implementation was also created. Finally, a graphically designed handbook for patients on LUTS including self-care was produced. This contains links to online pelvic floor and bladder training exercises . Future work will be directed towards successful implementation in Parkinson’s care settings

Assessment component of toolkit

management component of toolkit

Infographic regarding post void residuals

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MDS Abstracts - https://www.mdsabstracts.org/abstract/developing-a-toolkit-for-the-assessment-and-management-of-lower-urinary-tract-symptoms-in-parkinsonism/