In a nutshell
This study reviewed several treatment options for bladder problems in patients with Parkinson's disease (PD).
Some background
The bladder relies on muscles to contract and release for urination. The brain typically controls this process. However, in certain neurological conditions, the bladder no longer receives correct messages to release urine. This is a condition known as neurogenic bladder. Symptoms can include loss of bladder control, frequency, urgency and retaining urine. Neurogenic bladder can be associated with Parkinson's disease (PD).
The different treatment methods for neurogenic bladder in patients with PD are still unclear.
Methods & findings
This study analyzed 41 other studies including 1063 patients. Different treatment options included behavioral therapy, medications, Botox injections or surgery.
Behavioral therapy such as pelvic floor exercises showed significant benefits in urinary leakage and quality of life.
Tolterodine (Detrol) was the most effective medication for the treatment of neurogenic bladder in patients with PD. It also had the fewest side effects. Solifenacin succinate (Vesicare) was the only medication found to improve urine leakage for patients with PD. Desmopressin (Minirin) can be used in patients with PD for reducing urinating at night (nocturia). Amantadine (Symmetrel; a medication for PD) in a low dose (150mg) was also found to improve urinary symptoms and nocturia in patients with PD.
Botox injections were found to be useful in helping with loss of urine in a small study. Electrical stimulation was also found to improve urine loss and frequency of urination, but with no effects on nocturia.
The bottom line
This study reviewed several treatment options for patients with PD with neurogenic bladder.
The fine print
Most of the studies analyzed were small. Larger studies are needed to compare these different treatment methods for patients with PD.
Published By :
Neurourology and urodynamics
Date :
Nov 09, 2018
