Does Parkinson’s Cause Urinary Incontinence

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Are You At Risk For A Uti

UTIs are more frequent in older adults. If the following applies to you, you are at a higher risk of having UTIS:

• Urinary retention or neurogenic bladder
• Disposable incontinence products that arent changed regularly
• Alzheimers disease
• A history of UTIs
• Use of a catheter
• Regular incontinence
• Bladder prolapse

Older females who are postmenopausal are at a higher risk of UTIs, because they experience an estrogen deficiency after menopause . In older males, bladder stones, kidney stones, prostate issues, and a history of prostate infections increase the risk of UTIs.

What Are The Symptoms Of Utis In The Elderly

The most common sign of a UTI is a painful, burning sensation while urinating. Other classic signs include frequent urination, pelvic pain, fever, chills, or blood or abnormal color in urine. But for older adults and the elderly, symptoms can be much more convoluted.

Some older adults have slower or suppressed immune responses, secondary conditions that mask symptoms, or conditions like Alzheimer’s or dementia that make it difficult to recognize or communicate symptoms. Any of these factors can make recognizing a UTI in an older adult significantly more difficult.

Keep an eye out for the following symptoms if youre unsure an elderly patient has a UTI:

• Agitation
• Vomiting

Is Double Vision Due To A Problem In The Eye Or In The Brain

The key to understanding whether double vision is due to a problem in the eye or in the brain is to see what happens when one eye is closed. If there is double vision when looking with the right or left eye alone, then the cause is ophthalmologicalsuch as a cataract, a problem of the retina, or another eye disease.

On the other hand, when double vision is present with both eyes open, but goes away upon looking with only one eye, the cause may be neurological. This type of double vision occurs because of abnormal eye movements that cause the eyes to become misaligned.

When the eyes are not aligned properly, one eye sees an image in one location, while the other eye sees the same image in another location. Understandably, the brain becomes confused and sees two images instead of one. When one eye is closed, the double vision immediately goes away, because the brain receives information from just one eye.

Colour Vision Contrast Sensitivity And Low Light Conditions

A lack of dopamine-producing cells in the retina can cause problems with colour vision and contrast sensitivity. This means that it may be hard to distinguish between shades of the same colour, particularly blues and blue/greens. Some people also have difficulty defining images on a background of similar shades or colours and reading fine print, particularly in low light levels.

Levodopa and other Parkinsons medications may help with these problems. Your doctor will be able to advise you on this.

Patients With Parkinson Disease At Increased Risk Of Vision Eye Issues Study Shows

Patients with Parkinson disease were found to be more likely to experience vision and eye issues, such as blurry vision, dry eyes, trouble with depth perception, and problems adjusting to rapid changes in light, compared with people without the disorder, according to study findings.

Patients with Parkinson disease were found to be more likely to experience vision and eye issues, such as blurry vision, dry eyes, trouble with depth perception, and problems adjusting to rapid changes in light, compared with people without the disorder, according to study findings published in Neurology.

In patients with PD , irregular eyesight can prove a chief issue, as ophthalmologic disorders combined with postural and gait instability from the disorder may increase the risk of falls and fall-related injuries, noted the study authors.

Risk of vision impairment is potentially common for PwP because PD is linked with retinal dopamine depletion and decreased dopaminergic innervation of the visual cortex, which can lead to visual problems such as diminished oculomotor control, contrast sensitivity, color vision, and visuospatial construction. PwP are also at increased risk for seborrheic blepharitis and keratoconjunctivitis sicca .

In PwP with ophthalmologic symptoms, 68% reported that it interfered with daily activities, compared with 35% of controls .

Reference

Ophthalmologic Features Of Parkinsons Disease

This paper is a systematic evaluation of the ocular complaints and ocular finding of 30 PD patients with early untreated PD, and 31 control subjects without neurologic or known ocular diseases.  The ocular abnormalities found more commonly encountered by PD patients frequently respond to treatment.  Abstract and access to the full article.

Utis In Adults With Incontinence

Older adults who wear incontinence products are at an increased risk for exposing the urethra to E. coli, particularly if they are wearing the wrong products or if the products are not changed frequently enough. Soiled incontinence products, when left on too long, can introduce harmful bacteria into the urinary tract.

Addressing Practical Aspects Of Eating And Drinking

Some people with Parkinsons have problems chewing and swallowing. This can make it difficult to eat a diet with plenty of fibre. A speech and language therapist can give advice about this. Ask your GP, specialist or Parkinsons nurse for a referral.    If it takes a long time to eat and your meal goes cold, eat smaller portions and go back for seconds that have been kept warm. You can also get special plates that keep your meals hot the Disabled Living Foundation has more information. 

An occupational therapist will also be able to give you some tips and practical advice. 

Forms Of Urinary Incontinence That Affect Men Only

• Benign prostatic hyperplasia affects about 50 percent of men over the age of 60, and 90 percent over the age of 85; an enlarged prostate can cause sudden and frequent urges to urinate.
• Peyronies disease is the result of injury or damage to penile tissue, causing an abnormal curvature.
• Painful inflammation of the prostate gland

Management Of Reduced Functional Bladder Capacity

Antimuscarinic Agents

Antimuscarinic medications are the first-line treatment for bladder storage symptoms and detrusor overactivity. Oxybutynin, tolterodine, solifenacin, and trospium chloride have beneficial effects on nocturia. If prescribed, a low dose is initially recommended with a progressive increasing dosage. Furthermore, the strict respect of the scheduled taking is important in order to reduce nonurinary anticholinergic effects.

However, their side-effect profile, which corresponds to an increasing anticholinergic burden, limits their use. The risk of urinary retention has not been specifically assessed in PD. Consequently, a repeated PVR measurement is recommended. In addition, constipation was reported not to be increased in parkinsonian patients using antimuscarinics. Of particular concern is the impact on cognitive functions in patients with PD, especially in the elderly. Anticholinergic medications can add to the anticholinergic burden of antiparkinsonian therapy and thus to the cognitive dysfunction . Drugs such as trospium chloride or tolterodine, which do not cross the bloodbrain barrier, have may be preferred. However, evidence supporting these considerations in clinical practice is limited, and caution is advised when using an antimuscarinic agent in PD.

Vision: More Than Meets The Eye Tricks To Aid Pd Patients

Retired neurologist and young onset Parkinsons patient, Dr. Maria De León reminds us that vision is integral to our quality of life and safety, especially with respect to driving.  She lists 11 common eye problems with PD, and a few uncommon ones.  They may be helped by adjusting medications, with special lenses, or artificial tears.  See your doctor to find out.

Double Vision Is Common In Parkinsons Large Study Finds

Double vision is common in people with Parkinsons affecting up to an estimated 30% of patients and is linked to both motor and non?motor disease symptoms, a new large-scale, longitudinal study has found.

Parkinsons patients with double vision were more likely to be older, non-white, female, have had the disease for a longer time, and experience greater motor, non?motor, and daily activity limitations.

The positive news for patients is that the condition is easily treatable, researchers noted.

The study, Prevalence and risk factors for double vision in Parkinson disease, was published in the journal Movement Disorders Clinical Practice.

Visual impairment is reported by some Parkinsons patients, with one of the most common complaints being double vision. However, the investigators noted that clinical study groups are prone to under-ascertainment, as neurologists may not be comfortable addressing visual symptoms, and patients frequently do not disclose non-motor symptoms such as double vision unless specifically asked.

Patient Leaflets Team

How Is Neurogenic Bladder Diagnosed

A doctor will do an exam and may order several tests of the nervous system and the bladder to diagnose neurogenic bladder: These include:

• Urodynamic studies: These bladder function tests measure how much urine the bladder can hold, the pressure within the bladder, how well urine flows, and how well the bladder empties when it is full. Special sensors may be placed on the skin near the urethra or rectum to see if the muscles and nerves in those parts of the body are working properly.
• Cystoscopy: The doctor may perform this procedure to examine the inside of the bladder and urethra with the use of a small telescope .
• X-rays

Treating Utis In The Elderly

Most commonly, a prescription of antibiotics is required to treat a UTI. Amoxicillin and nitrofurantoin are often prescribed to treat UTIs, but there are some more severe cases that  will call for stronger antibiotics like ciprofloxacin or levofloxacin. You should go to the doctor to receive an antibiotics prescription as soon as you suspect a potential UTI. Starting as soon as possible can help to minimize discomfort and other related issues. Because some bacteria will still exist in your urinary tract even as symptoms fade, its crucial you take antibiotics for the duration of of your prescription, rather than stopping when you feel better. If you stop treatment early, bacteria can regrow, and youll build up a resistance to antibiotics if you are prescribed them again too soon.

If an older person is at a high risk for UTIs or experiences them multiple times a year, it is possible to disguss taking daily antibiotics to fend off UTIs. If it doesnt conflict with other medications or conditions, patients may also take over-the-counter pain relievers like ibuprofen or acetaminophen to ease the immediate pains associated with UTIs.

Parkinsons Disease And Voiding Dysfunction

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

Seek Out Advice From A Medical Practitioner

Sometimes people wait a little too long before visiting a medical practitioner for urinary incontinence. The proper urinary function is a part of life that you dont want to put off for a long period of time. It can get in the way of too many things, and you could potentially get the problem under control if you visit a medical practitioner for additional advice.

What Are The Symptoms Of Fecal Incontinence

The symptoms of fecal incontinence depend on the type.

• If you have urge fecal incontinence, you will know when you need to pass stool but not be able to control passing stool before reaching a toilet.
• If you have passive fecal incontinence, you will pass stool or mucus from your anus without knowing it.

Some medical experts include streaks or stains of stool or mucus on your underwearcalled soilingas a symptom of fecal incontinence.

Why Do Bladder Leaks Occur During Menopause

Your weakened pelvic floor makes it harder to control your bladder, especially when stress is placed upon it .  

How Is Neurogenic Bladder Treated

The main treatments for neurogenic bladder are the following:

• Clean intermittent catheterization : Catheters are thin, flexible tubes that can be inserted through the urethra and into the bladder to drain urine.
• Drugs: Medications are prescribed to improve your bladder function. Specific medications for neurogenic bladder depend on if your bladder is overactive or underactive or both.
• Injections of botulinum A toxin : A doctor injects Botox into the bladder or urinary sphincters.
• Bladder augmentation : This is a surgery in which segments of the intestine are removed and attached to the walls of the bladder. This reduces the bladder’s internal pressure and increases its ability to store urine.
• Ileal conduit: Part of the small bowel is used to make a urine stoma. This stoma drains to a bag attached to the outside of the body.
• Lifestyle changes: These might include avoiding certain foods or drinks that can irritate the bladder. These include certain caffeinated drinks like coffee, carbonated beverages, spicy foods, and citrus fruit. Losing weight can ease stress on the bladder. A behavioral treatment called delayed voiding may help some people with urine control.

Absorbent undergarments, pads, panty shields, panty liners, and adult diapers can help prevent wetness and odors while protecting skin and clothing. Bed pads can protect sheets and mattresses.

What Causes Incontinence In People With Dementia

In the later stages of dementia, a persons ability to react quickly and remember things is reduced. They may no longer recognize when they experience the urge to urinate or have a bowel movement. Reasons for incontinence in someone with dementia include:

• not recognizing the bathroom

• mental status changes or abrupt worsening of confusion, including significant changes in behavior

UTIs can worsen without proper treatment.

Treatment For Over Active Bladder In Parkinsons

Overactive bladder 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.

How You Can Tackle Your Loved Ones Incontinence

While it will be difficult to know when your loved one might experience urine leakage, the two of you will feel calmer and more relaxed if youre prepared.

Whether your loved one needs a little assistance or a lot of assistance, check out these guides for more incontinence care tips.

Diagnosis Of Constipation In Parkinsons Disease

Diagnosis of constipation may include: 

• medical history
• detailed description of symptoms
• physical examination.

Nerve Control Of The Bladder

The urinary bladder is a muscular pouch that collects urine until it is ready to be removed from the body. In a healthy urinary system, there is a series of muscles and sensory nerves that all signal the brain when the bladder is full.These same muscles also send out sensory signals making us consciously aware of the need for elimination. There are also voluntary muscles that allow us to continue holding urine until it is convenient to eliminate. All of these nerves and muscles work together to allow us to urinate in the right place, at the right time. In a neurologically compromised urinary system, signals are not transmitted properly, leading to bladder dysfunction.

• The urinary bladder is a muscular pouch that collects urine until it is ready to be removed from the body.

Urinary Issues In Advanced Parkinsons Disease

Urinary dysfunction and symptoms in PD are most commonly caused by overactivity of the detrusor muscle, or the muscle of the bladder, which contracts excessively despite the fact that it is not filled with urine. This causes an increased urge to urinate and/or an increased frequency of urination, which can be especially prominent at night. In advanced PD, this could culminate in urinary incontinence, or involuntary release of urine. Mobility issues which make getting to the bathroom slower and more cumbersome, compound the problem.

Always remember that people with advanced PD may have other medical problems that affect their urination such as an enlarged prostate. Make sure to have a complete evaluation before assuming that the problem is only related to PD. It is also essential to keep in mind that if changes in urination occur suddenly, there could be a urinary tract infection present.

Once other medical issues and urinary tract infection are ruled out, there are a number of approaches to the issue of urinary incontinence in a person with advanced PD:

Unfortunately, for some, the above available options may not be sufficient to effectively treat urinary incontinence in advanced PD. If this is the reality, it becomes extremely important to keep the skin dry with frequent changes of incontinence products to prevent skin breakdown and the potential development of skin infection.

Cardiovascular Dysautonomia And Nocturia

An association is known to exist between orthostatic hypotension and nocturia, and nocturnal polyuria. In health, blood pressure is known to decrease at night, and this is often absent in patients with PD reporting autonomic failure. This may be mediated through inappropriate mineralocorticoid receptor activation. Consequent to this, pressure natriuresis occurs, resulting in increased urine output and the patient reports nocturia. OH and supine hypertension frequently coexist in PD, and older age, akinetic-rigid motor subtype, and pre-existing hypertension are independent risk factors for supine hypertension. Improvement of nocturia, however, has not been a consistent finding in studies evaluating treatments for supine hypertension,, , and therefore cardiovascular dysautonomia is likely to be only one of several mechanisms responsible for nocturia in PD.

Eyekrafters Medical Optics Eye Clinic And Parkinsons And Vision Problems In South Plainfield New Jersey

Many eye diseases can be quickly and easily diagnosed during a comprehensive eye exam. If you were diagnosed with an eye disease, such as Cataracts, Glaucoma, Macular degeneration, Diabetic retinopathy, or Dry eye, you may be overwhelmed by the diagnosis and confused about what happens next. Will you need medications or surgery now or in the future? Our South Plainfield eye doctor has prepared the following answers to your questions about eye disease.

Who Do Utis Affect

UTIs affect women more than men due to the fact that women have shorter urethras than men do. Whats more, people become more at risk for developing UTIs as they age. More than 10 percent of woman older than 65 and 30 percent of women over 85 have had UTIs in the last year, one study claims.

For patients in nursing homes, more than one-third of all infections experienced are UTIs.

Reduced Functional Bladder Capacity At Night

Functional bladder capacity is diminished if the bladder wall compliance is reduced, the detrusor is involuntarily contracting , or if the bladder has incompletely emptied following a void. All three of these are known to occur in PD. Nocturia results whenever the urine volume produced at night exceeds the functional bladder capacity. Urodynamic evidence for detrusor overactivity has been reported in 45% to 93% of PD patients, , and correlates with scores in overactive bladder questionnaires. In urodynamic studies, 81.0% had storage disorder, 54.8% had abnormalities of storage and voiding, whereas 19.0% had only a voiding disorder.,

A likely mechanism for DO in PD is disruption of the dopamine D1-GABAergic direct pathway and its GABAergic collateral to the micturition circuit,, resulting in loss of inhibition of the micturition reflex and OAB. Severity of OAB symptoms has been shown to correlate with impairments observed on urodynamic testing and dopaminergic deficiency observed in dopamine transporter scans.,

What Causes Parkinsons Is It Curable Can It Cause Urinary Incontinence

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Management Of Incontinence In Patients With Parkinsons Disease

It is estimated that two-thirds of all patients with PD have some degree of bladder problems ranging from complete inability to empty the bladder to the more common problem of urinating too often and to the ability to make it to the bathroom in time . Common dysfunctions are bladder overactivity, causing urinary urgency, frequency, and incontinence . Getting up at night to use the bathroom is the most prevalently reported non-motor symptom with PD, reported by more than 60%. Weak voiding is also a common dysfunction. Patients may feel like they must go frequently, but when they go it may take longer than average to void.  Constipation is another common issue that may arise and being constipated can affect medication absorption. Some studies suggest that 80% of people who have Parkinsons Disease report constipation.

Patient should be educated to alert their health care provider is they have any of the following signs:

Treatment Options For Urinary Incontinence During Menopause

Bowel Incontinence: Another Embarrassing Casualty Of Pd

How To Prevent Utis In The Elderly

Sometimes urinary tract infections are impossible to prevent, but many steps can be taken to greatly reduce your chance of infection. Make sure you drink plenty of fluids daily and, if youre at a higher risk of UTIs, avoid diuretics like caffeine or alcohol. Make sure you upgrade to a more absorbent incontinence product and that it is changed frequently. Every time you use the bathroom, make sure you wipe from front to back and keep the area clean.

UTIs are often a regular part of life for older adults with incontinence, but with some baseline knowledge and the right preventative measures, can be easily avoided and managed.  

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Treatment Options For Urinary Incontinence During Menopause

Your doctor may recommend a number of different treatment options depending on the severity of your condition, and what type of incontinence you have. 

If youve found that bladder leaks have become a problem for you, whether youre going through menopause or not, we urge you to learn more about your condition and the treatment options out there and then talk to your doctor to figure out a plan to manage it together. 

Why Do Urgency And Frequency Occur

Bladder difficulties in Parkinsons are related to changes in the level of dopamine affecting the function of the bladder muscle. Parkinsons is also thought to affect the nerve pathway between the bladder and the part of the brain controlling bladder function. Some of the symptoms that affect bladder control are related to the level of dopamine in your body which will rise and fall depending on your medication level.

Other conditions such as weak pelvic floor muscles or an enlarged prostate will contribute to bladder symptoms. Constipation can also worsen bladder symptoms by putting pressure on the bladder.

#2 Like Parkinsons Vision Is Linked To The Brain

Vision plays such a critical function that a substantial portion of our brain is made up of pathways that connect our eyes to the visual areas of our brain and the areas that help process this visual information . The primary purpose of the front part of our eyes is to produce the clearest possible image, which is then transmitted to the back part of the eye, called the retina. The retina is made up of nerve cells that communicate via visual pathways using the neurotransmitter dopamine. In addition, we have two eyes with overlapping visual fields, which enables our brain to see the world in three dimensions and process complex visual information.  

Related Conditions And Causes Of Urinary Incontinence

Fecal incontinence is light to moderate bowel leakage due to diarrhea, constipation, or muscle or nerve damage.

As described in the section above on causes of urinary incontinence, common conditions may contribute to chronic urinary incontinence, including: urinary tract infection , constipation, interstitial cystitis or other bladder conditions, nerve damage that affects bladder control, side effects from a prior surgery, and neurological disorders.

Bowel Incontinence: Another Embarrassing Casualty Of Pd

Fecal Incontinence is where you lose control of your bowels.  This blog post explains the primary cause of this in Parkinsons 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.