Previous studies showed that 37-71% of the patients with idiopathic Parkinson's disease (IPD) or parkinsonism of other causes had urinary problems. There are several possible reasons for such wide range of frequency of urinary problems in
Parkinson's
disease or parkinsonism; (1) They used different questionaires on the urinary problems; (2) they did not try to differentiate the patients with idiopathic Parkinson's disease and those with multiple system atrophy(MSA), in which condition severe
urinary
problems occur frequently early in the clinical course or even before the onset of parkinsonian symptoms. However, exact nature of urinary problems in MSA and IPD has never been compared.
Using Boyarsky score, we compared the frequency and severity of urinary symptoms between 32 patients with IPD and 28 patients with probable MSA. All except one with MSA (96.5%) had urinary symptoms. Although 24 of the 32 with IPD(75%) also had
urinary
problems, the severity was milder than those with MSA. In 8 with MSA, urinary symptoms preceeded the onset of parkinsonian symptoms. No one with IPD developed urinary symptoms before the onset of parkinsonian symptoms. Seven out of the 28
patients
with
MSA voided more than 8 times during the day, 10 woke up more than 2 times to void during sleep, 20 wet their clothes more than 2 times per a day. However no one with IPD had such severe urinary problems. Careful history taking about the urinary
problems
seems to be a helpful way in differentiating IPD and MSA
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