Bladder dysfunction in Parkinson disease

Bladder dysfunction is common in Parkinson disease, especially in its late stages. Detrusor overactivity is most common, leading to urinary frequency and urgency, and sometimes to urge incontinence. Obstructive symptoms (eg hesitancy, weak urinary stream) also occur. Exclude prostatism in males.

In mild bladder dysfunction, restricting fluid intake in the evening may be sufficient treatment. Dopaminergic therapy does not usually relieve urinary symptoms. If additional treatment is needed, follow the advice for multiple sclerosis (botulinum toxin type A and sacral neuromodulation are less common therapies for patients with Parkinson disease).