enCATHopedia Volume 7

Parkinson’s and the bladder How Parkinson’s affects the bladder

Treating bladder problems CIC can help

Parkinson’s disease Parkinson’s is a progressive neurological condition. In people with Parkinson’s, some of the brain cells that create the chemical dopamine have died. These cells are needed to control physical motion and mood. The disease gets worse over time, but its progression affects people differently – as does its symptoms.

Parkinson’s is often diagnosed in a person’s 40’s or 50’s, but it can also be diagnosed much earlier. The disease is thought to be brought on by a combination of environmental and genetic factors, and is most often managed with medication. Because Parkinson’s is a nervous system disease, some – though not all – people with Parkinson’s can experience bladder function problems at some stage of their disease.

How Parkinson’s affects the bladder People with Parkinson’s may encounter the same bladder problem anyone else might. However, two conditions are commonly reported: urge incontinence and nocturia. These conditions (or any other bladder problem that a person with Parkinson’s might experience) may be a result of signal problems between the brain and bladder. Not everyone with Parkinson’s experiences bladder problems. But for those that do, the symptoms can get worse as the disease progresses.

Urge incontinence is also known as an overactive bladder (OAB). Someone with an overactive bladder experiences unwanted contractions that are difficult to control. They may feel the need to urinate immediately, without warning, even if the bladder is not full. OAB can be very disturbing, and some people may also experience leakage. Nocturia is the need to urinate several times during the night because of OAB. This wakes people up, or results in bed wetting. Interrupted sleep due to nocturia is one of the most common non-motor symptoms in people with Parkinson’s.

Managing bladder problems Because Parkinson’s affects motor control, frequently having to rush to the toilet can be inconvenient and may increase the risk for physical injury. Even clothing with small or difficult-to-manage buttons can be a challenge, leading to leakage accidents. Overall, bladder problems can have a significant effect on a person’s mood or desire to go out – which may contribute to depression, another common symptom of Parkinson’s. People with Parkinson’s have shared a number of ways to make life easier if bladder problems are part of the condition:

• Proper toilet height (not too high or low) makes it easier to get up and down. Rails on the wall can be helpful. • Tabs on zippers and oversize buttons can make it easier to remove clothing and help prevent accidents. • Constipation, another common symptom of Parkinson’s, may also obstruct the urethra and affect the bladder. The successful treatment of constipation is always necessary, and may have a positive effect on bladder problems. • Bladder problems or not, it is always important to drink fluids frequently throughout the day. Limiting fluid intake is dangerous, and will not solve bladder problems.

Self-catheterizing for people with Parkinson’s For people with enough motor control to handle a catheter, self-catheterization with a disposable catheter may be an option. Clean Intermittent Catheterization (CIC) is a safe and convenient way to empty the bladder. CIC empties the bladder completely, which can help relieve the symptoms of an overactive bladder. This prevents the frequent feeling of needing to “go” and enables a better night’s sleep.

• CIC is easy and safe, and while it may feel a little strange at first, it does not hurt • It is discreet and can be performed quickly anywhere where there are toilets • It prevents residual urine, reducing the risk of urinary tract infections • It empties the bladder completely, preventing the backflow of urine that could damage the kidneys • Because it empties completely, there’s less risk of urine leakage

Living with self-catheterization Bladder problems can make it hard to go about our normal day-to-day lives with confidence. CIC can help in many different ways. With a good single-use catheter, the procedure is quick, comfortable and discreet. Some people worry about going out in case there are leaks. Self-catheterizing helps prevent accidental leaking because it empties the bladder completely. Self-catheterization gives better control of when, where and how to empty the bladder. And self-catheterizing before going to bed helps empty the bladder completely, meaning fewer trips to the bathroom and a better night’s sleep.

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