Consensus expert recommendations for management of urinary dysfunction in Parkinson disease.

Abstract

Urinary symptoms may occur throughout all stages of Parkinson disease (PD) and adversely affect quality of life for patients and caregivers. Lower urinary tract symptoms are multifactorial and may include urinary urgency, frequency, nocturia, incontinence, and voiding dysfunction. These symptoms may be compounded by mobility impairment disrupt sleep and contribute to falls. An updated multidisciplinary framework is needed to integrate current evidence and evolving therapeutic options into clinical practice. To develop consensus recommendations for screening, diagnosis, and management of urinary dysfunction in PD. The application of a modified virtual Delphi panel allowed for the synthesis of expert opinions into clinical statements. A multidisciplinary expert panel comprising movement disorders neurologists, urologists, urogynecologists, and a geriatrician with expertise in lower urinary tract dysfunction conducted a targeted narrative review of PubMed. Draft statements were developed across four clinical domains: evaluation, PD-specific contributors, diagnostic work-up, and interventions and rehabilitation. Statements were discussed, revised, and voted on through a modified virtual Delphi process until consensus was achieved. The panel developed consensus recommendations and a unifying clinical algorithm to support screening, diagnostic evaluation, appropriate referral, and individualized multidisciplinary management. These consensus recommendations provide a structured approach to evaluate and manage urinary dysfunction in PD across clinical settings.