PARKINSON ASSOCIATION OF NORTHERN CALIFORNIA
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Bladder Problems: Is it Me or the PD?
by Norika Malhado-Chang, MD, Associate Professor of Neurology, UC Davis School of Medicine
Nobody likes to talk about it, but urinary symptoms are so common in Parkinson’s, it’s no coincidence
​we call it “Pee-D.”
 The truth is, up to 83% of people with Parkinson’s experience trouble controlling urine. This is not only an inconvenience, but a major detriment to quality of life. When we have to remain within a few yards of a bathroom, chances are that we may pass up an outing with friends or a family vacation. And road trips? Out of the question.
 
Talking to your Parkinson’s physician about bladder symptoms is the first step in getting your life back!
 
Just like the motor symptoms of PD, bladder dysfunction in PD is related to the loss of dopamine. When we lose this all-important chemical messenger, signals from the brain to the bladder get mixed up.  This confuses the bladder as to when it should empty, and when it should retain fluid. Therefore, the first question to answer is: are we talking about difficulty holding urine, or difficulty eliminating urine?
 
Trouble holding urine is the more common problem. The bladder becomes overactive and wants to empty, even if there is only a small amount of urine inside.  Nocturia (urinating at night), frequency (having to go all the time), urgency (having to go immediately), and incontinence (loss of control) are extremely common.  A urinalysis helps to rule out bladder infection.  We try to avoid drinking fluids after 6 pm to limit nocturia.  Timed voiding, where we use the bathroom on a set schedule, helps to minimize accidents.  Improving dopamine therapy helps our bodies move faster, to get us to the bathroom easier.  Medications might include anticholinergics (ex., Detrol or Vesicare) which lower stimulation to the bladder, or agents such as Myrbetriq, which help to relax the bladder muscle.  The older agents may worsen cognition and hallucinations but the new medications are somewhat safer.  Other treatments include tibial nerve stimulation and botulinum toxin injections into the bladder muscle.  It’s important to remember that any treatment that relaxes the bladder can result in unintentional urinary retention.
 
The less common problem is difficulty eliminating urine.  Incomplete bladder emptying is confirmed by checking a “post-void residual” via ultrasound in the office.  Urinary retention is important to treat, because stagnant urine in the bladder is susceptible to bacterial infection.  Weak bladder muscle is managed with intermittent catheterization.  Your physician may recommend referral to a urologist or urogynecologist, who may perform urodynamic testing to determine the underlying bladder disorder.
 
I recommend high absorbency pads at night.  Briefs with elastic around the legs and tabs on the sides work well, and gel briefs can hold more liquid than cellulose.  During the daytime, Depends-type undergarments or shields can help provide security and confidence to go out and live life. 


COVID-19: There is still limited information about the effects of COVID-19 specifically regarding Parkinson’s disease, having said that, given the frailty associated with Parkinson’s disease, it would be prudent to be cautious, prepared and follow the precautions recommended by public health departments/ CDC.   During these challenging times, it cannot be emphasized enough the need for all, PD community specifically and the
​community at large, to reach out to each other, offer support and assistance to those most vulnerable and share our resources.

​Our Mission

​​The Parkinson Association of Northern California is an organization dedicated to enhancing the lives of people with Parkinson's, their families, and care partners throughout our region. 
La Asociación de Parkinson del Norte de California se dedica a mejorar la vida de las personas con Parkinson, sus familias y los compañeros de cuidado. 

​Contacts

Email: panc@panctoday.org
Mailing Address:
Parkinson Association of Northern California
1024 Iron Point Road, #1046
​Folsom, CA 95630
​

Phone: (916) 357-6641
If you'd like more information please call the office 
Si le gustaría obtener más información por favor llame ​a la oficina.
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Copyright © 2020 Parkinson Association of Northern California. All rights reserved.
​PANC is a 501(c)(3)   Tax ID #68-0372037
  • PANC Home
  • About Us
    • Staff
    • Board of Directors
    • Medical Advisory Panel
    • Privacy Policy
    • Annual Report & 990's
  • Contact Us
  • About Parkinson's
    • COVID-19 Resources
    • Recently Diagnosed
    • PD Carepartners
    • Clinical Trials
    • Exercise!
    • Helpful Resources
    • PD Webinars & Classes
    • Guide to Specialist
    • Articles
  • Ways to Support
    • Donate Online
    • Donate by Mail or Phone
    • CAREPARTNER RESPITE SUPPORT
    • Be A Sustaining Donor
    • Planned Giving
    • Donate a Vehicle
    • AmazonSmile
    • Become a Support Group Facilitator
    • Other Ways to Give
  • Español
    • Sobre PANC
    • Clases y recursos
  • Programs/Support Groups
    • Support Groups
    • Respite Care
    • Parkinsonwise
    • Parkinsonwise Trained Professionals
    • Rebuilding Together
  • Newsletter
  • PD classes/events
    • Brian Grant Foundation December 2022 Classes
    • Davis Phinney Foundation -PD self 2023, Webinair series , Every Victory counts & many more
    • Family Caregiver Alliance Webinairs - Dec 22--Jan 23
    • Michael J Fox Foundation -1/19/23 Eating to Boost Brain Health
    • Parkinson 's Foundation Webinars, and events
    • Parkinson Voice Project - Speech exercises Daily 8 AM Info session 2nd Tu
    • PD Active Calendar of exercise, dance, singing & speech classes and support groups
    • PMD Alliance - Online and In person classes and support groups
    • World Parkinson Coalition Research spotlight 22, Sing-A-Long 12/14 WPC 23-7/4-7/7
  • DONATE