Pelvic Floor Health in Women with Parkinson’s Disease

Article type: Research Article

Authors: Gupta, Ankita^a | LaFaver, Kathrin^{b; 1} | Duque, Kevin R.^c | Lingaiah, Anushree^b | Meriwether, Kate V.^{a; 2} | Gaskins, Jeremy^d | Gomes, Josephine^e | Espay, Alberto J.^c | Mahajan, Abhimanyu^{c; 3; *}

Affiliations: [a] Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, University of Louisville School of Medicine, Louisville, KY, USA | [b] Division of Movement disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA | [c] James J. and Joan A. Gardner Center for Parkinson’s Disease and Movement Disorders, University of Cincinnati, Cincinnati, OH, USA | [d] Department of Bioinformatics & Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA | [e] Department of Family and Geriatric Medicine, University of Louisville, Louisville, KY, USA

Correspondence: [*] Correspondence to: Abhimanyu Mahajan, MD, MHS, 1725 W. Harrison Street, Suite 755, Chicago, IL 60612, USA. Tel.: +1 312 563 2030; E-mail: [email protected].

Note: [1] Present address: Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

Note: [2] Present address: Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics & Gynecology, University of New Mexico, Albuquerque, NM, USA

Note: [3] Present address: Section of Parkinson’s Disease and Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA

Abstract: 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.

Keywords: Parkinson’s disease, pelvic floor disease, urinary incontinence, urinary dysfunction, prolapse, health care utilization, women’s health

DOI: 10.3233/JPD-202491

Journal: Journal of Parkinson's Disease, vol. 11, no. 2, pp. 857-864, 2021