People with Parkinson’s disease may develop an overactive bladder. They can experience a frequent and desperate need to urinate even though their bladders are not full.
According to the American Association of Neurological Surgeons, 1.5 million people in the United States are living with Parkinson’s disease, with doctors diagnosing around 60,000 new cases each year.
The American Parkinson Disease Association (APDA) notes that around 80 in 100 people with Parkinson’s disease experience bladder problems, such as overactive bladder, at some time.
The Urology Care Foundation (UCF) explains that people with overactive bladder feel a sudden, strong need to urinate more than eight times a day. It adds that people who regularly wake to urinate more than once a night may also be experiencing symptoms.
This article explains why people with Parkinson’s disease may experience an overactive bladder and explores both medical and home treatments.
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Parkinson’s is a progressive disease that damages the nerve cells in a person’s brain that make dopamine. Dopamine is a neurotransmitter — a chemical messenger that carries nerve impulses to different parts of the body.
Dopamine is vital for coordinating movement. Dopamine also works on other bodily functions that are not movement-related. These include carrying nerve impulses to and from a person’s bladder.
The bladder is a muscular sac that holds urine. The muscle that makes up the bladder’s wall — the detrusor muscle — has two main functions: It contracts to squeeze urine out and relaxes to allow the bladder to fill.
When a person has an overactive bladder, signaling between their brain and bladder becomes confused. The person’s detrusor muscle signals that the bladder is full before it really is and starts squeezing urine into the person’s urethra. As the bladder contracts, the person experiences a need to urinate.
Usually, a person can control this urge, and their brain slows down the muscle contractions. However, when a person has Parkinson’s disease and lower dopamine levels, the message to slow the contractions is corrupted and the person feels an urgent need to urinate.
People with Parkinson’s disease may experience overactive bladder at any stage during the disease’s progression. It is not necessarily a sign that the illness is worsening.
The UCF explains that the main symptom of an overactive bladder is a sudden, pressing need to urinate. Some people may leak a little urine before they reach the bathroom.
The APDA adds that these symptoms may be worse at night, when the person is lying down.
Doctors may prescribe medications to treat a person’s overactive bladder.
The APDA notes that these treatments are not specific for people with Parkinson’s disease, but doctors often prescribe them. They include:
- mirabegron, which helps the bladder muscles relax
- antimuscarinics, including trospium and dirifenacin, which stop the detrusor muscle from contracting
- botulinum injections into the bladder
Many doctors recommend making lifestyle changes to help manage a person’s overactive bladder. These include:
- limiting coffee, and other caffeinated drinks
- limiting alcohol
- cutting back on tomato-based foods
- avoiding spicy foods
- limiting sodas, and other fizzy drinks
- doing exercises, including kegel exercises, to help strengthen the person’s pelvic floor
- planning bathroom breaks, and following a schedule to urinate at set intervals throughout the day
Doctors may also suggest the person delays emptying their bladder, gradually increasing the time between bathroom breaks. However, the UCF warns that this can increase the likelihood of urine leaks.
While an overactive bladder is the most common urinary problem for people with Parkinson’s disease, the APDA notes that some people experience an underactive bladder.
If a person has an underactive bladder, they may not be able to fully empty their bladder while urinating.
A person with Parkinson’s disease, or their caregiver, may wish to contact a doctor if the person is displaying signs of overactive bladder or other urinary issues.
A doctor can help to manage the symptoms through medication or provide advice on how to manage the condition.
Doctors rule out other causes before diagnosing a person with overactive bladder. They may test for urinary infections or prostate problems.
The UCF explains that doctors may ask the person to keep a bladder diary recording how much liquid they drink and when and how much they urinate.
Many people with Parkinson’s disease experience an overactive bladder at some stage during their illness. They feel a sudden, urgent need to urinate immediately.
Researchers have shown that age also plays a part, with people aged between 65 and 74 being more likely to experience overactive bladder.
Doctors may prescribe medications or recommend lifestyle changes to help the person manage their symptoms.