Urinary Dysfunction and Parkinson's with Arun Mathur

Dr. Arun Mathur, a urologist with specialized knowledge of Parkinson's, explains the symptoms, causes, and treatments of urinary dysfunction in people with Parkinson's.

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Time Stamps:
0:00 – Introduction
1:57 – Urinary Dysfunction Differences Between Neurologic Diseases
2:59 – What is Urinary Dysfunction?
7:22 –Urinary Dysfunction Can be Pre-Cursor to a Parkinson’s Diagnosis
8:40 – Urinary Dysfunction Greatly Impacts Quality of Life
12:32 – When You Should Seek Treatment
14:30 – Urinary Dysfunction is More Prevalent in Later Onset Parkinson’s
16:56 –Non-Pharmacological and Surgical Treatments
19:55 – DBS and Urinary Dysfunction
20:59 – Carbidopa/Levodopa’s Effect on Urinary Dysfunction
22:47 – Pharmacological Treatments
26:39 – Catheterization
29:05 – Prostate Symptoms versus Parkinson’s Symptoms
31:25 – When Will Non-Pharmacological Treatments Show Results

[Canucksway]

Parkinson’s disease (PD) has many features that have little or nothing to do with movement. Among these non-motor symptoms are problems with the autonomic nervous system — the part of the nervous system that controls “automatic” bodily functions, such as heart rate, blood pressure, sweating, sexual function and both gastrointestinal and urinary function. These symptoms are often among the most serious and complex issues faced by people with PD.

Unlike bowel dysfunction (e.g., constipation), which often occurs before Parkinson’s movement symptoms, urinary dysfunction is not typically a problem until the later stages of the disease.

Bladder Problems in Parkinson’s
The primary function of the bladder is twofold — to store urine as it is made and then to empty the urine. With Parkinson’s, problems can emerge in both areas.

Recent studies suggest that 30-40% of people with Parkinson’s have urinary difficulties. Despite the frequency of urinary dysfunction, actual urinary incontinence is relatively uncommon. Troublesome incontinence develops in only about 15% of people with Parkinson’s.

The most common urinary symptoms experienced by people with Parkinson’s are:

- The need to urinate frequently.
- Trouble delaying urination once the need is perceived, creating a sense of urinary urgency.

These symptoms usually mean you have an irritable or overactive bladder. Your bladder is signaling the brain that it is full and needs to empty when, in fact, it is not. This can happen at any time, so you might have to get up multiple times during the night to go to the bathroom.

Impairment of bladder emptying is a less frequent but still troublesome feature of urinary dysfunction in Parkinson’s. This may be caused by delay or difficulty in relaxation of the urethral sphincter muscles. These muscles must relax for the bladder to empty. This can result in hesitancy in initiating urination, difficulty in generating a stream and incomplete emptying of the bladder. Dystonia – involuntary muscle contractions – of the urethral sphincter has also been described.

Does having to poop put pressure on your bladder?
Large amounts of stool in the colon can put pressure on the bladder which can cause the bladder to not fill as much as it should, or cause the bladder to contract when the bladder is not supposed to contract. This large amount of stool can also cause the bladder to not empty well.

Can your bowels block your bladder?
Chronic rectal retention of feces could also lead to involuntary contraction of the pelvic floor muscles and the external anal sphincter, making bladder emptying difficult.

How to relax the bladder naturally?
Each time the urge to urinate occurs, the person should try to delay urination for 5 minutes if possible. Relaxation techniques, such as deep breathing, may help. People should gradually increase the holding time until there are 2–3 hour gaps between bathroom visits.

Can an inflamed colon put pressure on the bladder?
The bowels and the bladder are close to each other in the body. This means when one is experiencing issues, it may affect the other. For example, if your bowels are backed up or inflamed, they can put pressure on your bladder, increasing your urge to urinate and the frequency of peeing.

How can I regain my bladder function?
Do daily pelvic floor exercises. Pelvic floor exercises can be effective at reducing leaks. It's important to do them properly and include short squeezes and long squeezes. You can feel your pelvic floor muscles if you try to imagine stopping yourself peeing and farting.

[davesmithshaman]

Thank you I've diagnosed since 2013 told bluntly at back injury examination devasted me the wife of 27 yrs cheated and left me due to my diagnosis 😮 nhs is basic support tried counselling but didn't or couldn't talk bt parkinson just filled in mh suicide form treated for depression it's been a lonely road
But then I found your vids absolutely changed my thinking ❤thank you keep up ghe good workx

[bsingh]

Thank you Dr Mathur for this enormously empathic and human video. So much information, I have my first appt. coming up with a neuro urologist, I feel ready now !

[therealkathleenkiddo]

If only the local urologists were half as sensitive and respectful as Dr. Mather! It has been demoralizing and even dangerous to see urologists who do not seem to care or pay attention. One left me with a blocked ureter for one year I almost died. The other was without humanity or even basic human courtesy. I’d rather pee my pants! Dr. mather rocks!

[Raglafart]

That was such a wonderful talk. Thank you so much.👍

[dixiehuthmaker]

Excellent video. What a great amount of education!! I have Parkinson and am heading to the Urologist next week and now feel empowered! Thank you for this.

[GoProGoalieUzi]

Hi! Great information. I was diagnosed in 2018 with Pd at 40. At this point I have no issues with this topic..

[lindak]

is it possible that carbidopa /levedopa causes over active bladder?

[elysialeake]

Thanks for the education 🙂. I am a home health OT and have heard frequently from PD clients that they have little urinary output during the day, but will be up frequently at night to go, which can really interrupt the ability to get adequate sleep. Sometimes this seems like it could be related to lower extremity edema, but sometimes there is no observable edema. Any thoughts or solutions for this?

[johnkuruvila]

My husband has urgency of passing urine.he is wit parkinsonism. He has mild prostatic hypertrophy. Wat is the treatment please

[myleswhite]

Relieve bladder issues by resolving constipation issues less hard poop pressure on bladder more room for bladder function.

[OCloggs]

What about female in 50s with urinary retention, no leaking but waking up 2-3 times at night, slow stream and bladder doesn't feel fully relieved, is this a Parkinson's symptom?

[HeyKimmi]

does bladder botox actually help with neurogenic bladder due to Parkinsons?

[charlespomroy]

Just what I need, more drugs, I take about 10 now

[reginakay]

Had chronic constipation. The diagnosed Parkinson. Carvadopa increased constipation. Please address