Common non-movement issues of Parkinson's disease
Bladder symptoms typically emerge and worsen as Parkinson’s disease progresses.
In contrast, constipation can appear years before any Parkinson’s movement symptoms.
Key points
- Bladder dysfunction usually worsens as Parkinson's disease progresses.
- In Parkinson's disease, bladder changes typically involve two related problems:
- the valve controlling urine flow (sphincter) becoming underactive, leading to leaking
- the bladder muscle becoming overactive, leading to urgency and frequency.
- Practical guidance for patients includes pelvic floor exercises (Kegels), which can help both men and women; men may also benefit from practising stopping and starting the urine stream.
- Not all urinary symptoms in someone with Parkinson's disease are necessarily caused by Parkinson's disease. Routine urological review is important, as it helps you stay proactive about your health and ensures other treatable conditions, including prostate issues in men and prolapse in women, are not overlooked.
- Your GP or specialist can guide you through non-drug strategies and, where appropriate, discuss medication or procedural options suited to your individual symptoms and health profile.
Next steps:
Some of the common symptoms of Parkinson's related bladder disfunction are:
- a sudden, strong urge to urinate (urgency), sometimes with difficulty reaching the toilet in time
- difficulty starting the flow of urine (hesitancy), more often noticed in men and sometimes related to prostate enlargement
- frequent need to urinate, particularly waking multiple times overnight (nocturia)
- leaking with coughing, sneezing or physical exertion (stress incontinence), more often noticed in women, sometimes related to childbirth or pelvic organ prolapse.
Urinary symptoms are extremely common in the general population, and Parkinson's disease is only one of many possible causes. Other contributors include:
- age-related changes in bladder function
- certain medications, including some unrelated to Parkinson's disease
- diabetes or other metabolic conditions affecting fluid balance
- pelvic floor weakness, prior childbirth or pelvic organ prolapse in women
- prostate enlargement or other prostate conditions in men
- urinary tract infection.
When to consider specialist review
Speak with your GP or neurologist if urinary symptoms are not improving with simple measures or are significantly affecting your quality of life or sleep. Your doctor may refer you for a consultation with a urologist, who specialises in urinary issues.
New or changing urinary symptoms shouldn't automatically be attributed to Parkinson's disease. Routine urological review is a valuable part of ongoing care, as it can identify unrelated but important conditions that might otherwise be missed.
When to seek urgent help
Seek urgent medical attention for:
- blood in the urine
- fever with back or flank pain
- inability to pass urine at all
- severe lower abdominal pain.
These symptoms can indicate a separate problem, such as infection or urinary retention.