Stanford Parkinson's
Community Outreach

Incontinence in PD

Relevant Publications - Downloadable

“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.


"Understanding Bladder Symptoms in Parkinson's Disease - What You Need to Know"
Published by the American Parkinson Disease Association, Inc., 2017
Two-page fact sheet summarizes the urinary system, bladder dysfunctions associated with Parkinson's disease, evaluation of urinary problems and treatment options.
En Espanol:  "Sintomas Urinarios en la enfermedad de Parkinson - Lo que usted necesita saber"


"Urinary Dysfunction and Parkinson’s"
Published by the Parkinson’s Foundation, 2018
This one-page fact sheet explains that urinary dysfunction is one of several non-motor symptoms of Parkinson’s disease that are the result of Parkinson’s impairing proper function of the autonomic nervous system, especially in later stages of the disease process.  Several types of urinary dysfunction and treatment options are outlined.


Relevant Online Information

“4 Common Causes of Bladder Problems in Parkinson’s Patients,” by Dr. Maria De Leon
Published by, 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.


“Bladder problems”
Published by the European Parkinson’s Disease Association (EPDA)
Contents of this well organized and informative web page include normal function of the bladder and common bladder problems, how Parkinson’s affects the bladder, treating and managing bladder problems, self help and links to related reading.


“Bowel Incontinence: Another Embarrassing Casualty of PD,” by Dr. Maria De Leon
Published by, 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.


"Parkinson's Disease and Incontinence"
Published by the National Association for Continence
This page discusses the causes of bladder and bowel issues for those with Parkinson's disease, and both behavioral modifications and pharmaceutical treatment options for both.


“Treatment for over active bladder in Parkinson’s (revisited),” by Dr. Maria De Leon
Published by, 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.


“Urinary Incontinence”
Published by the Parkinson’s Foundation
This brief page confirms that people with Parkinson’s disease may experience bladder problems.  The most common of which are urinary frequency and urgency.  The page lists several medications that may help.  Tell your neurologist if you are experiencing urinary dysfunction.  You may be referred to a urology specialist.


“Urinary Problems”
Published by the UCSF School of Medicine, Parkinson’s Disease Clinic and Research Center
This page discusses why urinary problems (primarily ddificulty holding urine and difficulty eliminating urine) occur in PD. It recommends documenting specific signs of bladder problems and reporting them to your doctor and cites several management methods for these issues.


Relevant Online Lectures and Webinars

“Incontinence and Voiding Dysfunction in PD”
By Parkinson Canada, December 11, 2018
In this 54-minute webinar, urologist Dr. Sidney Radomski explains how voiding function is affected by Parkinson’s disease in both men and women.  He discusses how an enlarged prostate (benign prostatic hyperplasia) contributes to voiding problems and management options of voiding dysfunction for those with Parkinson’s disease and MSA.


“PD & The Bladder”
By the 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 Incontinence"
By the Iowa Chapter of the APDA, June 20, 2014
Urologist, Dr. Stephanie Pothoven, spoke at the 2014 Iowa Parkinson's Disease Conference.  She explains the healthy urinary system, the effect of incontinence on quality of life, how Parkinson's disease impacts voiding dysfunction, the process of determining the exact cause of the dysfunction, and treatment options.


“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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