Pelvic organ dysfunction is more prevalent and severe in MSA-P compared to Parkinson's disease

Neurourol Urodyn. 2011 Jan;30(1):102-7. doi: 10.1002/nau.20948. Epub 2010 Jul 23.


Aims: It is usually difficult to distinguish between idiopathic Parkinson's disease (PD) and parkinsonian-type multiple system atrophy (MSA-P) in the early stage. However, it is important to make a careful early-stage diagnosis. Therefore, we determined whether an examination of pelvic organ dysfunction would be helpful to distinguish between PD and MSA-P.

Methods: We recruited 61 patients with PD and 54 patients with MSA-P who were examined at our neurology clinic. The mean ages of the patients with PD and MSA-P were 67 and 64 years, respectively. The mean disease duration of both groups was 3.2 years. We administered a questionnaire on pelvic organ dysfunction to the PD and MSA-P groups. The questionnaire had sections focusing on bladder, bowel, and sexual function. Dysfunction, as described in the responses, was evaluated as normal, mild (>once a month), moderate (>once a week), or severe (>once a day). The Mann-Whitney U-test was used for statistical analysis.

Results: Compared with the PD group, the prevalence and severity of pelvic dysfunction in the MSA-P group was significantly higher for urinary urgency (MSA-P 76%, PD 58%, P<0.05), retardation in initiating urination (79%, 48%, P<0.05), prolongation in urination (79%, 72%, P<0.05), and constipation (58%, 31%, P<0.05). The quality-of-life index among pelvic organ dysfunctions indicated that urinary and bowel function was significantly more impaired in the MSA-P group than in the PD group.

Conclusions: Urinary urgency, retardation in initiating urination, prolongation in urination, and constipation are more prevalent and severe in MSA-P compared to PD.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Constipation / etiology*
  • Constipation / physiopathology
  • Diagnosis, Differential
  • Early Diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple System Atrophy / complications*
  • Multiple System Atrophy / physiopathology
  • Parkinson Disease / complications*
  • Parkinson Disease / physiopathology
  • Pelvis / physiopathology*
  • Prevalence
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Urinary Bladder Diseases / etiology*
  • Urinary Bladder Diseases / physiopathology