Urinary Dysfunction and Parkinson's with Arun Mathur

[@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.

[@caroliverach4212]

Thank you for a great video.

[@davesmithshaman23]

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

[@davisphinneyfdn]

Thanks for your message. We are here for you!

[@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!

[@davisphinneyfdn]

Yes he does!!

[@bsingh12]

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 !

[@davisphinneyfdn]

We're glad you found value from this video! Don't forget to bring notes to the appointment with your questions!

[@dixiehuthmaker1623]

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.

[@rhondastevens2268]

Good luck with your appointment Dixie. I have had parkinsons for 5 years now and full blown incontinence for 3.5 years .it is a big problem for me and I now won't go out too far from home..I now have urgency and get up at least3 times per night. My incontinence nurse has been a real godsend to me. She has been getting me a number of products to try. I am nit sure where yiulive but ere in Australia I have been trying some eversl types of pull up incontinence pants as far as I can tell, you can't buy from the supermarts nonsense

[@jeanettecohen56]

5

[@andredevilliers7827]

8

[@georgeannerhines3336]

😭

[@peterlyle4967]

😅

[@QuartersBarge]

Argah! Kilts are very practical.

[@Raglafart101]

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

[@davisphinneyfdn]

I'm glad you enjoyed it. Dr. Mathur shared so much practical information.

[@GoProGoalieUzi]

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

[@257rani]

Thanks Doctor Arun.❤🙏

[@pacifiquebusiness]

Thank you education

[@howardj2878]

Excellent discussion.

[@davisphinneyfdn]

Thank you, Howard!

[@myleswhite1792]

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

[@elysialeake9]

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?

[@davisphinneyfdn]

Thank you for watching, Elysia. I will ask Dr. Mathur about that.

[@lynmillen5624]

@@davisphinneyfdn mm kj

[@myfeastsorfamine7783]

For men, the condom catheter (external) is wonderful for the nightly needs. Game changer for us. Look for the one that 'unrolls' like a condom, without adhesive. It empties into a foley bag.

[@thrivegrowacademy]

@@myfeastsorfamine7783 where can you get this?

[@lindascanlan6317]

Fascinating. .ty

[@BruceAdams-f3v]

Where does Dr. Mathur work at?

[@johnkuruvila922]

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

[@usha1935]

In

[@usha1935]

Please

[@myfeastsorfamine7783]

Look into condom catheters (external). The one that rolls up like a condom, without adhesive, is best.

[@charlespomroy231]

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

[@lindak833]

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

[@davisphinneyfdn]

Carbidopa/levodopa (C/L) can have varied influence on bladder function. A 2007 study published in Neurology found, for example, that initial doses of C/L worsened bladder overactivity, but that longer term use of C/L improved bladder overactivity: n.neurology.org/content/68/18/1455. This article contains additional information as well: onlinelibrary.wiley.com/doi/10.1111/iju.12421

[@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?

[@davisphinneyfdn]

This does sound consistent with urinary issues related to Parkinson's. There are other possible explanations, though, so it is probably best to talk with a healthcare provider in your area.

[@OCloggs]

@@davisphinneyfdn Thank you so much for your reply, I will follow up on your advice.

[@HeyKimmi]

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

[@davisphinneyfdn]

Botulinum toxin can help some urinary issues associated with Parkinson's, but there are some indications for which it may not be helpful. A consultation with an experienced urologist can help evaluate the likelihood of successful treatment of individual circumstances. Notably, there are also some risks from use of botulinum toxin for bladder-related issues. Risks include urinary tract infections and difficulty or even inability to urinate.

[@justodanguilan6486]

Myself

[@usha1935]

😂m I’m iok 😮 hub g th f FCC

[@diapers4eva]

I have bladder Incontinence & wear disposable diapers & I have BOP, overflow Incontinence & I BS My surgeon said it's good that diapers work for me.

[@kimhefler]

What causes Parkinson

[@davisphinneyfdn]

Hi Kim - There is no one cause. Here's a quick primer on causes: www.hopkinsmedicine.org/health/conditions-and-diseases/parkinsons-disease/parkinsons-disease-risk-factors-and-causes

[@reginakay5133]

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

[@davisphinneyfdn]

Hi Regina - Here's a great conversation about constipation and the gut: kzbin.info/www/bejne/oKiVc4mVgdyZn80. Plus this article: davisphinneyfoundation.org/parkinsons-constipation/I hope these are helpful.

[@ginni333]

Linzess helped us

[@peterzing7483]

👍

[@frankcaparelli]

😢😅

[@sherrymargolis2922]

Bbbbb