Objective: To determine the relationship between psychoemotional and dysuria dysfunctions in patients with PD and MSA.

Background: In the group of patients with extrapyramidal pathology the possible correlation between psychoemotional and urinary disorders remains unclear.

Method: Patients with Parkinson’s disease (n=53) and multiple system atrophy (n=18), diagnosed according to modern criteria, were included. Parkinson’s disease stages were assessed using the Hoehn and Yahr (HY) scale. To estimate symptoms we used the bladder function assessment scale developed by us and the Hospital Anxiety and Depression Scale (HADS). Urodynamic testing (cystometry, pressure/flow) was performed in five patients with early stages of Parkinson’s disease.

Results: The patients were divided into two groups:

I – Parkinson’s disease – 53 patients, 2.9±1.0 HY (average);

II – multiple system atrophy – 18 patients.

In the given groups among patients with Parkinson’s disease, there was a statistically significant increase in the sum of storage scores and the total sum of scores (p<0.001), no statistically significant increase was noted as the severity of the disease stage increased (p=0.063). In multiple system atrophy patients the initial and late periods of the disease did not significantly differ in any of the above parameters.

The correlation of affective symptoms was as follows: in the Parkinson’s disease group there is a statistically significant, direct, moderate or noticeable correlation between symptoms of anxiety, depression and urological indicators with the sum of storage scores (p<0.001); voiding scores (p<0.001) and with the total sum of scores (p<0.001). Within the I group HADS subscale indicators (anxiety and depression) were compared between patients with and without lower urinary tract symptoms. Patients without urinary disorders demonstrated statistically significantly lower scores on both anxiety and depression subscales (p≤0.001). Urodynamic tests did not obtain urodynamic confirmation of the urinary disorders complained by patients.

Conclusion: At the early stages of Parkinson’s disease lower urinary tract symptoms are most often of a psychoemotional nature and are not confirmed by the results of an objective urodynamic testing.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neurogenic-bladder-and-affective-disorders-in-parkinsonism/