Parkinson's Disease Tulip


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Old 11-19-2007, 01:06 PM #1
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Default bladder function

I am wondering to what extent can PD affect the bladder. I had not had ANY problems up until late spring this past year. Since then, it's been infection after infection, urgency, spasms,pain, etc. I haven't been to a urologist yet; I think my physician is ready to send me to one, though.
If you don't mind being very specific and open about it, please shed some insight. I am at my wit's end and in pain. Nothing has changed in my "normal" routine, so all I can think is the plumbing ain't working so well due to neurological reasons.
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Old 11-19-2007, 03:32 PM #2
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Default It is fairly common

The repeated infections are unusual but the others are controlled by a part of the nervous system affected by PD.
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Born in 1953, 1st symptoms and misdiagnosed as essential tremor in 1992. Dx with PD in 2000.
Currently (2011) taking 200/50 Sinemet CR 8 times a day + 10/100 Sinemet 3 times a day. Functional 90% of waking day but fragile. Failure at exercise but still trying. Constantly experimenting. Beta blocker and ACE inhibitor at present. Currently (01/2013) taking ldopa/carbadopa 200/50 CR six times a day + 10/100 form 3 times daily. Functional 90% of day. Update 04/2013: L/C 200/50 8x; Beta Blocker; ACE Inhib; Ginger; Turmeric; Creatine; Magnesium; Potassium. Doing well.
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Old 11-19-2007, 08:07 PM #3
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Default

The bladder is a muscle. Sorry you are being so plagued!! Hope one of these will be helpful. If so, maybe print that take with to the doctor?


Evaluating Urinary Symptoms in Women with Parkinson's Disease

This is a PDF file of 6 pages. The file does not allow "select" function, so I can post excerpts.

Gastrointestinal Urinary Dysfunction in PD (from Parkinson's Disease Foundation [PDF]) This is a PDF file of 2 pages.

Excerpt:
Bladder and urinary difficulties
Bladder or urinary difficulties are also common in PD.

Older research studies indicated the presence of impaired urinary
function in slightly over 70 percent of PD patients,
although recent studies suggest a more modest frequency of
27 to 39 percent. Despite the frequency of urinary dysfunction,
actual urinary incontinence is relatively uncommon.
Troublesome incontinence develops in only about 15 percent
of individuals.

Unlike bowel dysfunction, which may precede (sometimes
by years) the development of motor features in people with PD,
urinary dysfunction typically does not become evident until the
later stages of the disease. The primary function of the bladder
is twofold — to store urine as it is formed and then to empty the
urine when it is convenient and socially acceptable to do so.
With PD, problems can emerge in both areas.

The most common urinary symptoms experienced by people
with Parkinson’s are first, the need to urinate extremely
frequently, and second, difficulty in delaying urination once
the need is perceived, creating a sense of urinary urgency.
These symptoms usually indicate an irritable or overactive
bladder that is signaling the brain that it is full and needs to
empty when, in fact, it really is not. In addition to urinary frequency
and urgency during the daytime, individuals with this
problem also may have to get up multiple times during the
night to urinate.

Medications that work to block or reduce bladder overactivity
can be useful in treating this form of bladder dysfunction.
A variety of medications are available for this purpose, including
older medicines such as oxybutynin and tolterodine, and
newer medications such as solifenacin and darifenacin.
Impairment of bladder emptying is a less frequent but
still troublesome feature of urinary dysfunction in
Parkinson’s. This difficulty is produced by delay or difficulty
in relaxation of the urethral sphincter muscles, which is
necessary to allow the bladder to empty. This can result in
hesitancy in initiating urination, difficulty in generating a
stream and incomplete emptying of the bladder. Dystonia of
the urethral sphincter has also been described.

The medications listed above are not helpful for this type of
bladder dysfunction and may actually aggravate the difficulty.
Medications such as bethanechol may be helpful but intermittent
self-catheterization is sometimes necessary. Before initiating
these, a doctor must make sure that some unrelated process,
such as an enlarged prostate, is not responsible for the problem.

The Bottom line
Both gastrointestinal and urinary problems are frequent
features of PD. Awareness of their existence and recognition
of their presence are the first necessary steps to adequate management.
People with Parkinson’s should not hesitate to bring
these problems to the attention of their physicians, especially
since effective treatment is often available.

Dr. Ronald F. Pfeiffer is Professor and Vice Chair of the
Department of Neurology at the University of Tennessee Health
Science Center. He has extensive experience in clinical trials of
experimental medications and has a particular interest in gastrointestinal
dysfunction in Parkinson’s disease.
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