Clinical study of the effects of deep brain stimulation on urinary dysfunctions in patients with Parkinson’s disease

Figures & data

Table 1 General health information of the two groups of patients with and without DBS

	PD patients without DBS	PD patients with DBS	P-value
Number of cases	196	220	0.303
Age (years)	60.9±6.1	61.3±5.9	0.528
Male/Female	148/48	160/60	0.569
Course of PD (years)	7.6±3.1	7.7±4.4	0.512
Course of urinary dysfunctions (years)	5.3±2.3	4.9±3.1	0.413
Male prostate volume (cm^3) Male PSA (ng/ml)	36.5±7.6 2.3±1.4	37.8±6.8 2.4±1.2	0.449 0.642

Abbreviations: DBS, deep brain stimulation; PD, Parkinson’s disease; PSA, prostate-specific antigen.

Table 2 Incidence of urinary dysfunctions in PD patients with and without DBS

	PD patients without DBS (n=196)	PD patients with DBS (n=220)	P-value
Nocturia	65.8% (129/196)	61.8% (136/220)	0.396
Urinary frequency	62.2% (122/196)	50.0% (110/220)	0.012
Residual urine feeling	44.9% (88/196)	42.7% (94/220)	0.655
Urinary urgency	44.4% (87/196)	32.3% (71/220)	0.011
Dysuria	37.8% (74/196)	34.5% (76/220)	0.498
Urinary incontinence	22.9% (45/196)	13.2% (29/220)	0.009

Abbreviations: DBS, deep brain stimulation; PD, Parkinson’s disease.

Table 3 Incidence of urinary dysfunctions in PD patients before and after DBS

	PD patients before DBS (n=220)	PD patients after DBS (n=220)	P-value
Nocturia	64.5% (142/220)	61.8% (136/220)	0.554
Urinary frequency	60.9% (134/220)	50.0% (110/220)	0.021
Residual urine feeling	45.0% (99/220)	42.7% (94/220)	0.632
Urinary urgency	46.4% (102/220)	32.3% (71/220)	0.002
Dysuria	35.0% (77/220)	34.5% (76/220)	0.920
Urinary incontinence	20.5% (45/220)	13.2% (29/220)	0.041

Abbreviations: DBS, deep brain stimulation; PD, Parkinson’s disease.

Table 4 Comparison of the assessment scales of urinary functions and urodynamic test results in PD patients before and after DBS

	PD patients before DBS (n=220)	PD patients after DBS (n=220)	P-value
AUA-SI	21.7±1.5	19.1±1.4	0.059
Symptom score during urination	13.6±3.2	13.0±3.1	0.454
Symptom score during bladder storage	8.1±2.2	6.1±2.4	0.032
OAB-SS	8.2±2.7	5.5±2.1	0.023
QOL	5.2±0.7	4.7±1.4	0.123
Qmax (mL/s)	13.0±2.9	13.7±3.8	0.122
First sensation of bladder filling (mL)	102.4±46.0	115.7±50.6	0.145
Maximum bladder capacity (mL)	271.4±46.0	288.1±48.3	0.211
Pdet Qmax (cmH2O)	30.1±7.1	31.5±7.6	0.445
Residual urine (mL)	76.8±11.8	70.1±12.5	0.476
Bladder compliance (ml/cmH2O)	30.2±5.1	30.7±4.2	0.554

Abbreviations: DBS, deep brain stimulation; PD, Parkinson’s disease; AUA-SI, American Urological Society Symptom Index; OAB-SS, Overactive Bladder Symptom Score; QOL, quality of life; Q_max, maximum Urinary Flow Rate; P_det, detrusor pressure at peak flow.

Table 5 Comparison of urinary functional assessment parameters and urodynamic test results in male PD patients before and after DBS

	Male PD patients before DBS (n=160)	Male PD patients after DBS (n=160)	P-value
AUA-SI	22.6±2.3	20.2±3.5	0.052
Symptom score during urination	13.8±3.4	13.6±3.1	0.473
Symptom score during bladder storage	8.8±1.2	6.6±1.5	0.021
OAB-SS	8.6±2.3	6.0±2.1	0.019
QOL	5.3±0.8	5.2±1.3	0.492
Qmax (mL/s)	13.0±2.1	13.1±3.6	0.430
First sensation of bladder filling (mL)	103.6±33.0	120.0±40.6	0.096
Maximum bladder capacity (mL)	289.4±47.8	276.8±30.2	0.083
Pdet Qmax (cmH2O)	30.1±6.3	29.0±5.1	0.291
Residual urine (mL)	80.6±8.9	79.2±6.8	0.398
Bladder compliance (ml/cmH2O)	29.3±4.5	29.0±2.7	0.217

Abbreviations: DBS, deep brain stimulation; PD, Parkinson’s disease; AUA-SI, American Urological Society Symptom Index; OAB-SS, Overactive Bladder Symptom Score; QOL, quality of life; Q_max, maximum urinary flow rate, P_det, detrusor pressure at peak flow.

Table 6 Comparison of the urinary assessment scales and urodynamic test results in female PD patients before and after DBS treatment

	Female PD patients before DBS (n=60)	Female PD patients after DBS (n=60)	P-value
AUA-SI	19.8±2.3	15.3±3.1	0.035
Symptom score during urination	13.1±3.5	10.6±3.8	0.038
Symptom score during bladder storage	6.7±2.7	4.7±2.2	0.033
OAB-SS	7.2±2.9	4.1±3.2	0.004
QOL	4.9±0.5	3.4±0.7	0.024
Qmax (mL/s)	13.1±2.9	15.4±6.0	0.034
First sensation of bladder filling (ml)	99.2±41.5	104.3±60.1	0.068
Maximum bladder capacity (mL)	223.5±40.8	318.3±38.2	0.039
Pdet Qmax (cmH2O)	30.2±7.1	38.3±7.8	0.043
Residual urine (mL)	66.7±10.8	45.9±6.4	0.041
Bladder compliance (ml/cmH2O)	32.5±5.6	35.2±4.7	0.124

Abbreviations: DBS, deep brain stimulation; PD, Parkinson’s disease; AUA-SI, American Urological Society Symptom Index; OAB-SS, Overactive Bladder Symptom Score; QOL, quality of life; Q_max, maximum urinary flow rate; P_det, detrusor pressure at peak flow.