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Introduction: Idiopathic normal pressure hydrocephalus (iNPH) is characterized by ventriculomegaly in association with the triad of gait disturbances, dementia, and incontinence. The purpose of this study was to provide a prospective evaluation of urinary symptoms in iNPH which has never been previously performed.
Materials & Methods: In a specialized iNPH clinic, patients with new-onset iNPH were prospectively evaluated by a neurourologist including a detailed history and physical and administration of questionnaires from the International Consultation on Incontinence to assess incontinence (ICIq-UI), OAB (ICIq-OAB), and quality of life (ICIq-LUTqol) related to lower urinary tract symptoms, as well as the AUASS bother scale. Patients were evaluated prior to any neurosurgical (shunt procedures) or urologic treatments or interventions.
Results: 55 consecutive patients with iNPH completed the initial evaluation and surveys. Total urinary incontinence score was mild to moderate (8.71 ± 0.64: 0-21 scale) with 90.9% experiencing leakage and 74.5% reporting urge incontinence. The most common OAB symptom was 2 times/night nocturia (2.2 ± 0.14: 0-4 scale) with urge incontinence the most bothersome (3.71 ± 0.44: 0-10 scale). Quality of life impact was moderate (4.47 ± 0.4: 0-10 scale) and AUASS bother scale was 2.89 ± 0.22.
Conclusions: Patients with iNPH present with mild to moderate incontinence of which nocturia is the most common symptom and urge incontinence is the most bothersome. To our knowledge, this is the only prospective evaluation of urinary symptoms in patients with new onset iNPH.