Urinary incontinence

Causes of bladder issues in Parkinson’s

The neurological changes in Parkinson’s can disrupt the coordination of messages between the brain and the bladder. Medications commonly used to manage symptoms, such as anticholinergics or dopaminergic therapies, may also contribute to bladder control issues.

People with Parkinson’s often experience a sudden and overwhelming need to urinate, referred to as urgency, which can occur with little warning. This symptom, along with frequency (needing to pass urine often) and nocturia (waking up at night to urinate), is commonly seen in Parkinson’s.

Parkinson’s medications can influence urinary symptoms. As the effect of the medication fluctuates, particularly during “wearing off” periods, the bladder may respond with increased urgency. This interplay between medication levels and bladder control is a crucial consideration in managing these symptoms.

Additionally, stiffness and slowness of movement can make it challenging for you to reach the bathroom in time. Pelvic floor dysfunction, possibly worsened by reduced physical activity or age-related changes, can further contribute to urinary incontinence.

Management Strategies

Addressing these factors typically involves a holistic approach that may include medication adjustments, pelvic floor exercises, behavioural therapies, and managing coexisting conditions like urinary tract infections to improve bladder control.

Continence Health Australia recommends that anyone experiencing urinary urgency should discuss these symptoms with their healthcare provider. Management may involve:

• Medication adjustments: Make sure that your Parkinson’s medications are timed appropriately. It can help reduce bladder symptoms.
• Bladder training & pelvic floor exercises: These non-invasive strategies that a physiotherapist can help you with may improve bladder control.
• Managing related issues: For instance, addressing constipation is important because it can exacerbate bladder problems by increasing pressure on the bladder.
• Referral to specialists: Consultation with a neuro-urologist or a continence nurse specialist may be advised if symptoms persist or worsen.

How do I access supports?

It’s advisable to explore all available pathways to find the support that best suits your individual needs. Look to:

• getting a GP referral to someone with Parkinson‘s experience
• your state-based Parkinson’s organisation for advice
• Ask Izzy https://askizzy.org.au/ to search for local services to access
• private health to see what is covered in relation to consultations and expenses
• DVA, NDIS or My Aged Care plan supports.