Neurogenic bladder in parkinsonism: effect of thalamotomy

✓ In a group of 62 patients with Parkinsonism, 44 had significant bladder dysfunction, although only one had acute urinary retention. Twenty-five showed a hyperactive type of detrusor function with decreased capacity and an increased volume/pressure response on cystometrography. Of these 25 patients, 23 had marked somatic rigidity with or without tremor. In contrast, 19 patients had hypoactive function manifested by an increased bladder capacity and a decreased volume/pressure response shown in the cystometrogram; of this group 11 had marked tremor with very little rigidity. Forty-nine patients underwent one or more stereotaxic thalamotomies. The effect of surgical therapy on both types of bladder dysfunction was generally favorable in 40 of these patients whose somatic manifestations were satisfactorily controlled.