Journal
JOURNAL OF PARKINSONS DISEASE
Volume 11, Issue 2, Pages 857-864Publisher
IOS PRESS
DOI: 10.3233/JPD-202491
Keywords
Parkinson's disease; pelvic floor disease; urinary incontinence; urinary dysfunction; prolapse; health care utilization; women's health
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Women with Parkinson's disease self-reported more urinary symptoms and had higher scores indicating pelvic floor dysfunction compared to controls, showing a gap in care for these patients. Pelvic floor dysfunction, more common in women with Parkinson's disease, is often underreported and undertreated, emphasizing the need for better management strategies.
Background: Urinary dysfunction and constipation, manifestations of pelvic floor dysfunction are common sources of disability and impaired quality of life in women with Parkinson's disease (PD). Objective: We sought to evaluate the pelvic floor health amongst women with PD and their reporting of bladder and bowel symptoms. Methods: We surveyed women with PD and age-matched controls about pelvic floor health using validated questionnaires. All participants completed the Pelvic Floor Disability Index (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Patient-Reported Outcomes Measurement Information System (PROMIS) short form version 2.0 Cognitive Function 8a. Additionally, PD patients underwent the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scale and the Montreal Cognition Assessment (MoCA). Results: Women with PD (n = 59; age, 70.4 +/- 8.6 years, PROMIS cognitive score, 52.0 +/- 7.8) self-reported urinary symptoms to a greater extent than controls (n = 59; age, 70.2 +/- 8.7 years, PROMIS cognitive score, 51.0 +/- 10) (68% vs 43%, p < 0.01). The difference was mirrored by higher (worse) scores on both PFDI-20 (35.4 vs 15.6; p = 0.01) and PFIQ-7 (4.8 vs 0; p < 0.01) for PD women compared to controls. Only 63% of all participants with self-reported pelvic floor symptoms had previously reported these symptoms to a health care provider. There was no difference in utilization of specialty care between the two groups (30% vs 46%, p = 0.2). Conclusion: Pelvic floor dysfunction, more common amongst women with PD, is underreported and undertreated. Our study identifies a key gap in care of women with PD.
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