M Godmer1, A Guinet-Lacoste2, K Charvier3, J Luauté4, G Rode5, J M Soler6, N Hadiji7. 1. Service de médecine physique et de réadaptation, rééducation neurologique, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Service de MPR pédiatrique neurologique, Centre Médical Romans Ferrari, rue de la Chanal-Miribel, 01700 Miribel, France. Electronic address: marie.godmer@gmail.com. 2. Hôpital Henry Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France. Electronic address: amandine.guinet-lacoste@chu-lyon.fr. 3. Hôpital Henry Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France; Service d'urologie Pr-Alain-Ruffion, centre hospitalier Lyon Sud, Hospices Civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France. Electronic address: kathleen.charvier@chu-lyon.fr. 4. Service de médecine physique et de réadaptation, rééducation neurologique, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Université de Lyon, université Lyon 1, 69100 Villeurbanne, France; Centre de recherche en neuroscience de Lyon (CRNL), équipe IMPACT, Inserm, U1028, CNRS, UMR5292, 69675 Bron, France. Electronic address: jacques.luaute@chu-lyon.fr. 5. Service de médecine physique et de réadaptation, rééducation neurologique, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Centre de Recherche en Neurosciences de Lyon, ImpAct Team, Institut National de la Santé et de la Recherche Médicale U1028, Centre National de la Recherche Scientifique UMR5292, Université Claude Bernard Lyon 1, Lyon, France. Electronic address: gilles.rodes@chu-lyon.fr. 6. Laboratoire de neuro-urologie et de sexologie, Centre Bouffard, Vercelli, 66290 Cerbère, France. Electronic address: jmsoler66@aol.com. 7. Hôpital Henry Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France; Service de neuro-urologie, Centre Médical Germaine-Revel, 69440 Saint-Maurice-sur-Dargoire, France. Electronic address: naderhadiji@yahoo.fr.
Abstract
OBJECTIVE: To highlight the existence of pseudo-dyssynergia in Idiopathic Parkinson's Disease (IPD) constituting a functional bladder outlet obstruction. MATERIALS AND METHODS: A retrospective study was conducted by including men with a confirmed diagnose of IPD who participated in the SIROCCO rehabilitation program. Patients included clinically exhibited overactive bladder and voiding dysfunction without prostatic hypertrophy ultrasounded. They have been clinically assessed by the Urinary Symptoms Profile (USP) urinary symptom score. Bladder outlet obstruction was assessed by the pressure-flow study. Urodynamic obstruction has been quantified by the bladder obstruction index which depends on detrusor pressure at maximum flow rate and maximum flow rate. It has been defined by a BOOI>40. RESULTS: The pressure-flow profile was analyzed in 5 patients who met the inclusion criteria. In this group of 5 patients with IPD, the diagnosis was made on average 10.6 years (7-14) before the pressure-flow studies were performed. Our results objectified 4 patients obstructive among 5 and one equivocal patient. A striated pseudo-dyssynergia was found in the 3 obstructive patients and associated with a smooth pseudodyssynergia in one patient. CONCLUSION: We have observed, in this short series, a pseudo-dyssynergia by subjects suffering from IPD. LEVEL OF EVIDENCE: 3.
OBJECTIVE: To highlight the existence of pseudo-dyssynergia in Idiopathic Parkinson's Disease (IPD) constituting a functional bladder outlet obstruction. MATERIALS AND METHODS: A retrospective study was conducted by including men with a confirmed diagnose of IPD who participated in the SIROCCO rehabilitation program. Patients included clinically exhibited overactive bladder and voiding dysfunction without prostatic hypertrophy ultrasounded. They have been clinically assessed by the Urinary Symptoms Profile (USP) urinary symptom score. Bladder outlet obstruction was assessed by the pressure-flow study. Urodynamic obstruction has been quantified by the bladder obstruction index which depends on detrusor pressure at maximum flow rate and maximum flow rate. It has been defined by a BOOI>40. RESULTS: The pressure-flow profile was analyzed in 5 patients who met the inclusion criteria. In this group of 5 patients with IPD, the diagnosis was made on average 10.6 years (7-14) before the pressure-flow studies were performed. Our results objectified 4 patients obstructive among 5 and one equivocal patient. A striated pseudo-dyssynergia was found in the 3 obstructive patients and associated with a smooth pseudodyssynergia in one patient. CONCLUSION: We have observed, in this short series, a pseudo-dyssynergia by subjects suffering from IPD. LEVEL OF EVIDENCE: 3.