Chapter 12 - Parkinson's disease

Summary

In addition to motor symptoms, Parkinson's disease (PD) involves many brain regions other than the substantia nigra. This chapter discusses bowel dysfunction, colonic transit time study, recto-anal videomanometry and sphincter electromyography, bladder dysfunction, surgery for prostate disease, and the management of bladder symptoms in PD. Studies have shown that total colonic transit time is increased in 80% of PD patients, which translates into an increased average colonic transit time ranging from 44 to 130 hours in PD and 89 hours in de novo PD patients, all of which are longer than those of controls. In PD, resting and squeezing anal pressure and motor unit analysis of the external sphincter muscles are mostly normal except in patients with longstanding disease. In contrast to constipation and disorders of the bowel, bladder dysfunction as part of PD occurs relatively late and is thought to result from central rather than peripheral nervous system abnormalities.