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Lower Urinary Tract Symptoms in Men With Parkinson Disease

Robinson, Joanne P.; Bradway, Christine W.; Bunting-Perry, Lisette; Avi-Itzhak, Tamara; Mangino, Marie; Chittams, Jesse; Duda, John E.

Journal of Neuroscience Nursing: December 2013 - Volume 45 - Issue 6 - p 382–392
doi: 10.1097/JNN.0b013e3182a3cf67
Article

Purpose: The aim of this study was to examine the prevalence, presentation, and predictors of lower urinary tract symptoms (LUTS) in men with idiopathic Parkinson disease (PD).

Methods: Guided by the Theory of Unpleasant Symptoms, this retrospective exploratory study used data abstracted from admission clinical records of 271 male patients with idiopathic PD enrolled in a movement disorders clinic at a large metropolitan Veterans Affairs Medical Center in the eastern region of the United States. Data from the admission questionnaire, Unified Parkinson’s Disease Rating Scale, and Mini Mental State Examination were abstracted by trained research assistants. Interrater reliability for the abstraction process was 0.99 in a randomly selected 10% sample of records. Descriptive statistics were used to determine the prevalence of LUTS. Logistic regression was used to determine LUTS risk factors and predictors.

Results: At least one LUTS was reported by 40.2% of participants. Incontinence was the most prevalent symptom, affecting almost 25% of participants, followed by nocturia (14.8%) and frequency (13.7%). Of the 10 identified risk factors for LUTS, four significant predictors were discovered: number of non-PD medications (p < .05), PD duration (p < .05), number of comorbidities (p < .05), and history of a hernia diagnosis (p < .05).

Conclusions: Assessment for LUTS should be a component of every evaluation of a patient with PD. Our findings offer a preliminary profile of the male PD patient with LUTS, which is an important step toward effective screening, detection, and access to care and treatment. Next steps in research include further work to identify predictors of LUTS in both male and female PD populations, explore patient perspectives, begin trials of interventions for LUTS in the PD population, and analyze the economic impact.

Questions or comments about this article may be directed to Joanne P. Robinson, PhD RN GCNS-BC FAAN, at jprobins@camden.rutgers.edu. She is a Dean and Professor at Rutgers, The State University of New Jersey, School of Nursing-Camden, Camden, NJ, and an alumna of the Edmond J. Safra Foundation Visiting Nurse Faculty Program on Parkinson’s Disease.

Christine W. Bradway, PhD RN FAAN, is an Associate Professor at the University of Pennsylvania School of Nursing, Philadelphia, PA, and an alumna of the Edmond J. Safra Foundation Visiting Nurse Faculty Program on Parkinson’s Disease.

Lisette Bunting-Perry, PhD RN, co-directs the Edmond J. Safra Foundation Visiting Nurse Faculty Program on Parkinson’s Disease and was the Assistant Clinical Director of the Parkinson’s Disease Education, & Clinical Center, Veterans Affairs Medical Center, Philadelphia, PA.

Tamara Avi-Itzhak, DSc, is an Associate Professor at the Department of Occupational Therapy, School of Health and Behavioral Sciences, York College, City University of New York, Jamaica, NY.

Marie Mangino, MSN RN GNP-BC, is an alumna of the Edmond J. Safra Foundation Visiting Nurse Faculty Program on Parkinson’s Disease and directs Vincent Healthcare, Erdenheim, PA.

Jesse Chittams, MS, is a Biostatistician at University of Pennsylvania School of Nursing, Philadelphia, PA.

John E. Duda, MD, directs the Parkinson’s Disease Research, Education, & Clinical Center, Veterans Affairs Medical Center, Philadelphia, PA, and is an Associate Professor of Neurology at the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

The authors declare no conflicts of interest.

© 2013 American Association of Neuroscience Nurses