APDA American Parkinson Disease Association
Information & Referral Center

Incontinence in PD

Relevant Publications - Downloadable

“Bladder Control and Parkinson's”
By Parkinson’s Australia, June 2014
This 3-page fact sheet explains the most common ways Parkinson’s can affect bladder control, why they occur, and what can help.

“Continence in MSA”
Published by MSA Trust, July 2015
This 6-page fact sheet addresses bladder dysfunction specifically in Multiple System Atrophe, but the symptoms, investigation to find the appropriate treatment, advice, and treatment options are similar enough to those of Parkinson’s disease, as to be useful here.

"Gastrointestinal and Urinary Dysfunction " by Dr. Ronald Pfeiffer
Parkinson's Disease Foundation Newsletter, Spring 2007
This 2-page fact sheet discusses dental problems and saliva, dysphagia, stomach problems, bowel dysfunction, bladder and urinary difficulties as they relate to Parkinson’s Disease, as well as possible treatments for each issue.

"Incontinence & Parkinson's Disease"
Published by the American Parkinson Disease Association, Inc., 2009
Four-page educational supplement defines incontinence, the frequency of occurrence in Parkinson’s Disease, how Parkinson’s Disease contributes to the difficulty, possible treatments and learning to live with the problem.
En Espanol:  “La Incontinencia en la Enfermedad de Parkinson”

"Urinary Problems in Parkinson's Disease"
Published by the National Parkinson Foundation
Two-page information sheet describes common symptoms of incontinence in Parkinson's Disease and their causes, with suggestions for keeping track of symptoms for reporting to your health care provider, as well as management tools.

Relevant Online Information

“4 Common Causes of Bladder Problems in Parkinson’s Patients,” by Dr. Maria De Leon
Published by defeatparkinsons.com, March 28, 2014
Urinary or bladder issues tend to be worst in late stages of PD.  More severe at the onset is most likely a parkinsonism or Parkinson Plus syndrome (like MSA).  Loss of dopamine mixes up the message from the brain to the bladder and confuses when it should empty or retain urine.  To find the proper solution you and your doctor, or team of physicians (often required for successful treatment), must first understand the cause - or causes.  Here are the 4 more common reasons for PD patients to experience bladder dysfunction.

“Bowel Incontinence: Another Embarrassing Casualty of PD,” by Dr. Maria De Leon
Published by defeatparkinsons.com, May 28, 2015
Fecal Incontinence is where you lose control of your bowels.  This blog post explains the primary cause of this in Parkinson’s disease.  Problems reaching the toilet in time because of mobility, abdominal bloating or cramping compound the problem.  Dr. De Leon has included a check list of things to help minimize occurrences and embarrassment, even to the point of surgery, if necessary.

“Treatment for over active bladder in Parkinson’s (revisited),” by Dr. Maria De Leon
Published by defeatparkinsons.com, October 5, 2014
Overactive bladder (OAB) affects up to 27% of men and 43% of women of the global population.  Now, add a neurological condition and the problem becomes more challenging.  First, there is a list of medications which make the problem worse, so should be avoided.  Then, a thorough evaluation and physical exam.  Treatment depends on the cause, but evaluating all medications and an adjustment of dopamine medication is often necessary.  If you are still having problems, five further treatment options are included.

Relevant Online Lectures and Webinars

“PD & The Bladder”
By UCSF School of Medicine, Parkinson’s Disease Clinic and Research Center, November 2014
In this 30-minute video lecture Dr. Donna Deng explains the cause of bladder dysfunction and quality of life consequences.  Treatment options include behavioral modification, pharmacologic, nerve stimulation (sacral nerve stimulation can also help bowel dysfunction), Implantable Impulse Generator, and Botox injections.  Last line of treatment for older men with Parkinson’s should be prostate surgical procedures

“Urinary Problems in Parkinson’s Disease”
By the Michael J. Fox Foundation, April 20, 2017
This 1-hour webinar is an interview with Dr. Janis Miyasaki, Dr. Jorges Juncos, and retired movement disorder specialist and young onset Parkinson’s patient, Dr. Maria De Leon.  They discuss the effect of Parkinson’s disease on the autonomic nervous system, which regulates many body functions, including bladder control.  Urinary problem diagnosis, symptom management and ongoing research on the topic wrap up the hour.

Expert-Level Resources

“The Management of Urinary Incontinence,” by Jennifer A. Wilson and Rashi C. Waghel
US Pharmacist, September 16, 2016; 41(9): 22-26
This article, written for Pharmacists, is not specific to Parkinson’s disease, but is an overview of urinary incontinence (UI) that includes: what constitutes UI, quality of life issues that warrant treatment, normal functioning of the system (including a mention of the central nervous system’s control over smooth-muscle activity, urinary sphincters relaxing and contracting to enable urine flow), five types of UI, the diagnostic process, nonpharmacologic and pharmacologic treatments.

This list compiled by Denise Dagan with Stanford's Parkinson's Community Outreach Program, April 2012. Links last updated by Denise Dagan, February 2017.

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