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In this article, Kapoor et al. reviewed recent advances in effective management of lower urinary tract dysfunction in idiopathic Parkinson's disease (PD).[1] PD is a common neurodegenerative disorder associated with loss of dopaminergic neurons. In addition to its motor symptoms, such as tremor, slow gait and easy fall, patients with PD often show non-motor symptoms. The non-motor problems of PD include neuropsychiatric disorders, sleep disorders, sensory symptoms and autonomic disorders. Bladder dysfunction is one of the most common autonomic disorders, the incidence being estimated to be 27–80%. Studies have shown that bladder dysfunction has great significance in relation to quality-of-life measures, early institutionalization and health economics. It is particularly important to note that, unlike motor disorders, bladder dysfunction is sometimes non-responsive to levodopa, suggesting that it occurs through a complex pathophysiology. This is because the pathology of PD is not confined to the degeneration of dopaminergic neurons in the substantia nigra, which seems to inhibit the micturition reflex, and involves other locations in the brain and other neurotransmitter systems than the dopaminergic system. For this reason, add-on therapy is required to maximize patients’ quality of life. The authors reviewed the pathophysiology of bladder dysfunction in PD, lower urinary tract symptoms, objective assessment and treatment including surgical intervention. Transurethral transection of the prostate for comorbid prostate hypertrophy in PD patients seems to be not contraindicated if multiple system atrophy, a more progressive disease that leads to urinary retention, is excluded. The collaboration of urologists with neurologists is highly recommended to maximize patients’ quality of life.

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