Incontinence in PD

Urinary incontinence is the loss of bladder control, resulting in leakage of urine.  It can be a non-motor symptom of Parkinson's disease (PD).  In some cases incontinence can be resolved, or it can be managed in various ways to fit your lifestyle and personal preferences.  Here are some resources to understand incontinence and how to cope with it.

Downloadable Documents | Online Articles | Podcasts & Webinars | Expert-level Resources


Downloadable Documents (PDF)

Continence in MSA

Published by MSA Trust, July 2017

This 6-page fact sheet (PDF) addresses bladder dysfunction specifically in Multiple System Atrophe, but the symptoms, investigation to find the appropriate treatment, advice, and treatment options are similar enough to those of Parkinson’s disease, as to be useful here.

Understanding Bladder Symptoms in Parkinson's Disease - What You Need to Know

Published by the American Parkinson Disease Association, Inc., 2019

Two-page fact sheet (PDF) summarizes the urinary system, bladder dysfunctions associated with Parkinson's disease, evaluation of urinary problems and treatment options.
En Español:  Sintomas Urinarios en la enfermedad de Parkinson - Lo que usted necesita saber

Urinary Dysfunction and Parkinson’s

Published by the Parkinson’s Foundation, 2018

This one-page fact sheet (PDF) explains that urinary dysfunction is one of several non-motor symptoms of Parkinson’s disease that are the result of Parkinson’s impairing proper function of the autonomic nervous system, especially in later stages of the disease process.  Several types of urinary dysfunction and treatment options are outlined.

Online Articles

Bladder problems

Published by the European Parkinson’s Disease Association (EPDA)

Contents of this well organized and informative web page include normal function of the bladder and common bladder problems, how Parkinson’s affects the bladder, treating and managing bladder problems, self help and links to related reading.

Bowel Incontinence: Another Embarrassing Casualty of PD

By Maria De León, MD.  Published by, May 28, 2015

Fecal Incontinence is where you lose control of your bowels.  This blog post explains the primary cause of this in Parkinson’s disease. Problems reaching the toilet in time because of mobility, abdominal bloating or cramping compound the problem.  Dr. De León has included a check list of things to help minimize occurrences and embarrassment, even to the point of surgery, if necessary.

Parkinson's Disease and Incontinence

Published by the National Association for Continence

This page discusses the causes of bladder and bowel issues for those with Parkinson's disease, and both behavioral modifications and pharmaceutical treatment options for both.

Treatment for over active bladder in Parkinson’s (revisited)

By Maria De León, MD.  Published by, October 5, 2014

Overactive bladder (OAB) affects up to 27% of men and 43% of women of the global population.  Now, add a neurological condition and the problem becomes more challenging.  First, there is a list of medications which make the problem worse, so should be avoided.  Then, a thorough evaluation and physical exam.  Treatment depends on the cause, but evaluating all medications and an adjustment of dopamine medication is often necessary.  If you are still having problems, five further treatment options are included.

Urinary Incontinence

Published by the Parkinson’s Foundation

This brief page confirms that people with Parkinson’s disease may experience bladder problems.  The most common of which are urinary frequency and urgency.  The page lists several medications that may help.  Tell your neurologist if you are experiencing urinary dysfunction.  You may be referred to a urology specialist.

Urinary Problems

Published by the UCSF School of Medicine, Parkinson’s Disease Clinic and Research Center

This page discusses why urinary problems (primarily ddificulty holding urine and difficulty eliminating urine) occur in PD. It recommends documenting specific signs of bladder problems and reporting them to your doctor and cites several management methods for these issues.

Podcasts & Webinars

MSA and the Bladder

By the MSA Coalition, October 24, 2020

This talk, presented by Dr. Michael Guralnick, a urologist at Froedtert Hospital in Milwaukee, focuses on urinary frequency, urgency, and incontinence. These are bladder symptoms of both MSA and PD.
Webinar Notes on the Stanford PD Community Blog

Evaluating and Treating Urinary Issues in Parkinson's Disease, Multiple System Atrophy, and the Other Atypical Parkinsonism Disorders

By the Stanford Movement Disorder Center and Brain Support Network, August 23, 2019

In this hour-long webinar, neuro-urologist Ekene Enemchukwu, MD focuses on urinary incontinence, overactive bladder, urinary retention, and other urinary issues in PD, MSA, and the atypical parkinsonism disorders.  Following the presentation, moderator Candy Welch, Brain Support Network’s MSA caregiver support group leader, asks Dr. Enemchukwu many questions submitted by webinar participants.
Webinar notes on the Brain Support Network Blog

Parkinson's Disease and the Bladder

By the UCSF School of Medicine, Parkinson’s Disease Clinic and Research Center, November 2014

In this 30-minute video lecture Dr. Donna Deng explains the cause of bladder dysfunction and quality of life consequences. Treatment options include behavioral modification, pharmacologic, nerve stimulation (sacral nerve stimulation can also help bowel dysfunction), Implantable Impulse Generator, and Botox injections.  Last line of treatment for older men with Parkinson’s should be prostate surgical procedures.

Parkinson's Disease and Voiding Dysfunction

By Parkinson Canada, December 11, 2018

In this 54-minute webinar, urologist Dr. Sidney Radomski explains how voiding function is affected by Parkinson’s disease in both men and women.  He discusses how an enlarged prostate (benign prostatic hyperplasia) contributes to voiding problems and management options of voiding dysfunction for those with Parkinson’s disease and MSA.

Understanding Urinary Incontinence

By the Massachusetts Chapter of the APDA, April 2022

In this 50-minute webinar urologist Linda Ng, MD, explains how the urinary system works, the effect of incontinence on quality of life, how Parkinson's disease causes voiding dysfunction, specific tests to determine the exact cause of the dysfunction, and potential behavioral, medical, and surgical solutions.

Urinary Dysfunction in Parkinson’s

By PMD Alliance, June 1, 2020

Dr. Jalesh Panicker specializes in urinary issues in people with neurologic disorders.  In this one-hour webinar he discusses the urinary problems that can arise in PD, including urgency, frequency, and nighttime urination, touching on why these issues occur in PD and what can be done about them.  
Webinar notes on the Stanford PD Community Blog

Urinary Incontinence

By the Iowa Chapter of the APDA, June 20, 2014

Urologist, Dr. Stephanie Pothoven, spoke at the 2014 Iowa Parkinson's Disease Conference.  She explains the healthy urinary system, the effect of incontinence on quality of life, how Parkinson's disease impacts voiding dysfunction, the process of determining the exact cause of the dysfunction, and treatment options.

Urinary Problems in Parkinson’s Disease

By the Michael J. Fox Foundation, April 20, 2017

This 1-hour webinar is an interview with Dr. Janis Miyasaki, Dr. Jorges Juncos, and retired movement disorder specialist and young onset Parkinson’s patient, Dr. Maria De Leon.  They discuss the effect of Parkinson’s disease on the autonomic nervous system, which regulates many body functions, including bladder control.  Urinary problem diagnosis, symptom management and ongoing research on the topic wrap up the hour.

Expert-Level Resources

The Management of Urinary Incontinence

By Jennifer A. Wilson and Rashi C. Waghel.  US Pharmacist, September 16, 2016; 41(9): 22-26

This article, written for Pharmacists, is not specific to Parkinson’s disease, but is an overview of urinary incontinence (UI) that includes: what constitutes UI, quality of life issues that warrant treatment, normal functioning of the system (including a mention of the central nervous system’s control over smooth-muscle activity, urinary sphincters relaxing and contracting to enable urine flow), five types of UI, the diagnostic process, nonpharmacologic and pharmacologic treatments.

Last updated August 2020 by Stanford Parkinson's Community Outreach.