Clinical features in Parkinson’s disease: characterization of urinary symptoms according to Parkinson disease subtype

• Published in: International urology and nephrology Vol. 57; no. 8; pp. 2495 - 2501
• Main Authors: Gubbiotti, Marilena, Ditonno, Francesco, Brahimi, Elona, Rosadi, Stefano, Rubilotta, Emanuele
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.08.2025; Springer Nature B.V
• Subjects: Aged; Agonists; Anxiety; Bladder; Cognitive ability; DNA nucleotidylexotransferase; Dopamine; Female; Humans; Lower Urinary Tract Symptoms - etiology; Male; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Movement disorders; Nephrology; Neurodegenerative diseases; Parkinson Disease - classification; Parkinson Disease - complications; Parkinson Disease - physiopathology; Parkinson's disease; Quality of Life; Severity of Illness Index; Software; Statistical analysis; Tremor; Tremor (Muscular contraction); Urinary incontinence; Urinary tract; Urology; Urology – Original Paper; Urinary incontinence; Clinical features; Urinary symptoms; Autonomic disorders; Parkinson’s disease
• ISSN: 1573-2584; 0301-1623; 1573-2584
• DOI: 10.1007/s11255-025-04435-z

Purpose To evaluate whether lower urinary tract symptoms (LUTS) differ among clinical subtypes of PD and the association between urinary disorders and motor and non-motor features, quality of life (QoL), and disease variables. Methods Subjects underwent to the unified Parkinson’s disease rating scale (UPDRS) motor section part III, Hoehn–Yahr (H&Y) scale and mini-mental state examination (MMSE) to evaluate motor symptoms, the stage of disease severity, and cognitive function, respectively. Patients were divided into tremor-dominant type (TDT), akinetic-rigid type (ART), and mixed type (MXT) PD subgroups. Urinary symptoms were evaluated with 3-day voiding diary, uroflowmetry, and the incontinence quality of life questionnaires (I-QoL); psychological status by Hamilton anxiety scale (HAM-A) and Hamilton depression scale (HAM-D). Results 52 patients were enrolled; mean (± SD) age: 66.5 ± 9.6 yrs. All patients complained about at least one LUTS: 92% had urgency, 83% had increased urinary frequency, and 77% had nocturia. Disease duration was positively related to an increase in urinary frequency ( p  = 0.06), nocturia ( p  = 0.03), and negatively related to Qmax ( p  = 0.01). The rate of urinary frequency increased with the increase of HAM-D score ( p  < 0.001). The number of nocturia episodes was expression of more severe disease, as expressed by UPDRS ( p  < 0.001) and worse scores in HAM-A ( p  = 0.01) and HAM-D scores ( p  = 0.04). A correlation was observed between urinary frequency and HAM-A scores ( p  = 0.01). No significant different was observed between the clinical subtypes. Conclusion Our results suggest that LUTS correlate with the severity of motor and non- motor impairment, demonstrating also that LUTS occurrence was irrespective to PD clinical features.