How Parkinson's affects the bladder
While the bladder is being filled a person isn’t conscious of the process. When the bladder is full it sends a signal to the brain that it’s time for emptying. The brain – consciously now – keeps the bladder from emptying until the person is ready. Then, the brain gives the bladder the go ahead to release. The part of the brain that controls this process is in the basal ganglia, where Parkinson’s symptoms originate.
People with Parkinson’s may experience an unstable or irritable bladder that contracts when it contains low amounts of urine. These contractions aren’t strong enough to cause the bladder to empty, but they do create a strong urge to urinate – urinary urgency.
The unstable bladder
Messages from the brain telling the bladder to hang on and relax don’t get through properly. Instead of being able to delay finding a toilet, you experience urgency. If you can’t reach the toilet in time, incontinence may result. This is called “urge incontinence”. Your bladder may also need emptying more often than before, and may wake you at night, or even empty while you sleep.
Difficulty emptying
Your Parkinson’s may give you problems with starting to empty your bladder because you have trouble maintaining bladder contractions until the bladder is quite empty; the bladder doesn’t start contracting when you want it to; the sphincter doesn’t relax to allow urine out; or a combination of these.
This means residual urine is often left in the bladder. This may cause a feeling of needing to empty the bladder very often, and, if the residue is large enough, overflow as an uncontrollable dribbling.
This incomplete emptying can be worse for people taking anticholinergic drugs such as Artane or Disipal.
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