Parkinson's Disease And The Bladder

Parkinsonism is a term given to the group of conditions that exhibit symptoms such as slowness of movement, rigidity and tremors - a common example of such a condition would be Parkinson's disease.

Some sufferers of Parkinsonism may, at some stage of their affliction, experience problems with their bladder. These bladder or bowel problems can be a real nuisance for the person who is also dealing with the Parkinsonism disorder (which may itself affect other things such as movement and mobility).

The bladder's function is to act as storage for urine once this has been made in the kidneys and then to totally empty itself. On average, a "normal" bladder can store approximately a pint of urine and will need to be emptied about four to six times daily.

The actual way in which the bladder works - when the bladder is relaxed it can fill, and it can empty itself when it is contracted so that the urine is squeezed out, it quite a complex procedure. It can only occur through complex coordination of the nerves and muscles and very long pathways between the brain and bladder.

The problems that sufferers of Parkinsonism may experience are
i) A difficulty in emptying the bladder
ii) An unstable bladder.

A difficulty in emptying the bladder may occur because the sphincter is not relaxed enough to allow the urine out or because the bladder doesn't start to contract when needed. Or there could be a problem in maintaining a bladder contraction long enough to ensure all the urine is out.

In any case, a small amount of urine often remains in the bladder which gives the urgent feeling of having to empty the bladder again and again. To make matters worse, urine infections tend to be commonplace amongst people who are unable to empty their bladder completely as the urine residue is a breeding ground for bacteria.

An unstable bladder is caused when the messages from the brain to the bladder are not getting through properly. For instance, you feel the need to go but try to delay it whilst you are looking for a toilet, the message from the brain instructing the bladder to hang on and relax isn't getting through properly so as a result you experience urgency - if you are unable to find a toilet in time, you may find you have wet yourself. This is also known as "urge incontinence".

Urine problems tend to become worse during the night as sufferers of Parkinsonism often have reduced dopamine levels at this time, which makes it an even harder task to physically climb out of bed, walk to the toilet, and, having got there, to begin to empty the bladder. It is not uncommon for people with Parkinsonism to have sleepless nights, or at least, nights that are disturbed continuously by fruitless visits to the toilet.





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