Urinary Bladder Problems in Parkinson's disease

Abstract

Prevalence of lower urinary tract symptoms (LUTS) in Parkinson’s disease (PD) patients is reported to range from 38% to 71%. 1 Common symptoms include nocturia, urinary urgency, incomplete bladder emptying and urinary retention. These symptoms may also be caused by urinary tract infection, prostatic hypertrophy, diabetes mellitus or medications used for other medical conditions. In some cases patients may not be able to make it to the washroom on time during the OFF period, particularly at night when the plasma level of the medications is low leading to incontinence. Bladder problems do not typically occur in the beginning of the Parkinson’s disease. If the patients have urinary dysfunction at the onset of Parkinson’s disease then atypical parkinsonism such as multiple system atrophy should be considered in the differential diagnosis. PD patients have reduced bladder capacity together with detrusor overactivity and uninhibited external sphincter relaxation, which contribute to these symptoms. Detrusor overactivity can be the major contributing factor to overactive bladder in PD. 1 Paradoxical cocontraction of urethral sphincter muscle has been described as an off period phenomenon. A study done by Araki et al found the LUTS was well correlated with the severity of the disease