Blasenstörungen bei Parkinson-Syndromen

Zusammenfassung

Diese Übersicht behandelt Blasenstörungen im Rahmen von Parkinson-Syndromen, ein für viele Patienten sehr beeinträchtigendes Problem. Früh im Verlauf auftretende Blasenstörungen sind typisch für eine Multiple Systematrophie, Normaldruckhydrozephalus und Parkinson-Syndrom bei subkortikaler vaskulärer Enzephalopathie. Bei dem idiopathischen Parkinson-Syndrom liegt die Prävalenz von Blasenstörungen bei 40% und nimmt altersabhängig zu. Das am häufigsten beklagte Symptom ist die Nykturie. Imperativer Harndrang und vermehrte Miktionsfrequenz führen insbesondere bei schlechter Beweglichkeit zur Dranginkontinenz. Eine suffiziente Dopaminersatztherapie ist Grundlage der Therapie. Daneben stehen für den imperativen Harndrang Anticholinergika, in Einzelfällen Desmopressin und Botulinumtoxin für die Therapie zur Verfügung, wobei Therapiestudien zu Blasenstörungen bei ParkinsonSyndromen fehlen.

Summary

This review covers urinary symptoms in parkinsonism. Urinary symptoms represent an impairing problem which is often neglected. Urinary symptoms early in the course of a parkinsonian syndrome are typical for multiple system atrophy, normal pressure hydrocephalus and parkinsonism associated with subcortical vascular encephalopathy. The prevalence of urinary symptoms in Parkinson’s disease proper is about 40% and increases with age. The most common complaint is nycturia. Urge and increased frequency especially in combination with impaired mobility cause urge incontinence. A sufficient dopaminergic therapy is the basis for any further management of urinary symptoms in Parkinson’s disease. Urge is also treated with anticholinergics, occasionally desmopressin and botulinum toxin, although there are almost no data addressing the issue in the setting of parkinsonism.

Schlüsselwörter

Parkinson-Syndrom - Blasenstörungen - Dopaminergika - Anticholinergika - Botulinumtoxin

Keywords

Parkinson’s disease - urinary symptoms - dopaminergics - anticholinergics - botulinum toxin

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