Parkinson’s disease is a neurological condition that causes stiffness and tremors. But it also affects many other bodily functions, including urination.
Urinary dysfunction is a lesser-known but not rare complication of Parkinson’s disease (PD). Symptoms include a frequent urge to urinate, difficulty holding in urine, and in some cases, unintentional urination (incontinence).
This article explains urinary system symptoms that have been linked to PD.
Bladder problems, such as the inability to fully empty your bladder and the inability to hold in urine, are among the non-motor symptoms of with Parkinson’s, especially in late stages of the disease.
The authors of a 2022 research review evaluated 73 studies on urinary dysfunction in PD that included nearly 15,000 total participants. They reported that around 30% of the study participants experienced an inability to urinate, an inability to empty their bladder, or urinary incontinence.
More broadly, they reported that around 61% of people with PD experienced lower urinary tract symptoms that affected their ability to urinate or hold in urine.
PD is caused by damage to certain nerve cells (neurons) in your brain, and it causes an imbalance in the chemical messengers (neurotransmitters) that control your muscle movements. Additionally, medications used to treat PD can lead to communication problems between neurons and your bladder, a condition known as neurogenic bladder.
Your bladder muscle might contract more or less often than it should, triggering urinary symptoms.
Other Parkinson’s complications that affect urination are described below.
Frequent urination
PD can leave you feeling like you have to urinate often.
According to a 2017 research review, frequent urination affects 32–71% of people with PD.
Increased nighttime urination (nocturia)
Nocturia is when you have to get up often to urinate throughout the night.
The same 2017 review notes that nocturia affects 57–86% of people with PD and is the most commonly reported urinary symptom among people with PD.
Urinary urgency
If you have PD, you may experience an increased sense of urgency when you notice that you have to pee. You may have trouble holding in your urine until you can get to a bathroom. This can sometimes result in leaks, a condition known as urge incontinence.
If you experience urinary urgency, you might suddenly feel that you have to go but may be able to hold it in until you get to a toilet. But if you have urge incontinence, you can’t hold it in when you suddenly get the urge to urinate. According to the authors of the 2022 review above, urinary urgency affects about 46% of people with Parkinson’s.
Hesitancy, intermittency, and straining
These symptoms involve having difficulty starting to urinate (hesitancy), starting and stopping (intermittency), producing a slow stream, and straining to urinate.
Known as voiding symptoms, they’re slightly less common in PD than overactive bladder symptoms are. But they still affect 20–30% of people with PD.
Urinary retention
Urinary retention is when your bladder doesn’t fully empty, even though you’ve just gone to the bathroom. It’s also sometimes called incomplete voiding, and it affects around 27% of people with PD.
Urinary tract infections (UTIs)
A UTI can happen when bacteria or other pathogens infect part of your urinary tract.
UTIs are common, particularly in older people. But people with PD have double the chance of being admitted to a hospital for a UTI compared to those without PD, according to research cited in a separate
People with PD are at an increased risk due to many of the symptoms listed above, including frequent urination and increased urgency. UTIs can make PD symptoms worse.
There are a range of treatment options for urinary symptoms caused by Parkinson’s disease. A doctor might refer you to a bladder problem specialist (urologist) for treatment.
Bladder training
Bladder training is a form of behavioral therapy that involves using urge suppression methods to delay urination for longer and longer periods.
This is a common first-line treatment for overactive bladder in people with PD. According to the 2016 review mentioned above, some small studies have suggested that it may help reduce incontinence, but more research is needed.
Timed voiding
Timed voiding is another form of behavioral therapy that may help reduce symptoms such as increased frequency and urgency. It involves following a schedule to urinate, whether you feel like you have to go or not.
Pelvic floor exercises
Bladder training may involve exercises to strengthen your pelvic floor muscles, which you have to contract to hold in urine and release to expel urine. These exercises, known as Kegels, may help with incontinence caused by PD.
Medication
If your urinary symptoms don’t go away with behavioral interventions, a doctor might prescribe medication to reduce bladder muscle contractions. The following drugs are meant to treat specific types of bladder dysfunction or symptoms and may help relieve urinary frequency and urgency:
- darifenacin (Enablex)
- oxybutynin (Oxytrol, Ditropan XL)
- tolterodine (Detrol LA, Detrol)
If you or someone you care for has PD, you might be looking for answers to the following questions.
Can Parkinson’s disease cause urinary problems?
Yes, PD can cause urinary problems. Some of the most common issues are frequent urination, urinary urgency, unintentional urination (incontinence), and increased nighttime urination (nocturia).
Why does Parkinson’s cause frequent urination?
Researchers do not know exactly how urinary problems develop in PD. But some believe that the disease affects urination and that some medications used to treat PD can cause side effects that affect urination.
UTIs are a main cause of:
- bladder urgency
- discomfort
- nocturia
- incontinence
If you develop these symptoms, it’s important to get medical attention. Bladder problems should not be ignored because they can be symptoms of other health conditions, such as:
- enlarged prostate
- prostate cancer
- cervical cancer
- colon cancer
What stage of Parkinson’s does incontinence or urinary dysfunction start?
Urinary dysfunction can happen in the early stages of Parkinson’s disease. The authors of a
Bladder and urinary problems are not rare in people with PD. Some of the most frequently reported issues are frequent urination, increased urgency, and incontinence. Some people with PD also experience difficulty emptying their bladder, although this is less common.
Many factors can contribute to bladder problems in PD, and experts are not yet sure exactly why these problems happen.
To learn more about available treatments, speak with a healthcare professional about your symptoms.