The term, Parkinsonism, is used to describe a group of conditions that exhibit symptoms such as slowness of movement, rigidity and tremors. A well known and common example of such a condition would be Parkinson's disease.
At some stage of their affliction, some sufferers of Parkinsonism may experience problems with their bladder. These bladder (and/or bowel) problems can affect the person's quality of life to a great degree. A decrease in the ability to move to the bathroom when needed is just one cause of the person's embarrassment.
A normal bladder can store about a pint of urine and will need to be emptied four to six times per day. The bladder's function is to act as storage place for the urine and it will normally empty itself totally when the person urinates.
While the bladder may seem like a simple storage organ, it is actually a very complex organ. The bladder can fill while it is in the relaxed state. And it can empty when it is contracted, thus the urine is squeezed out. The nerves and muscles that do this work are complex, and the nerves require long pathways from the brain to the bladder.
Because of this complexity, people suffering from Parkinson's disease may experience difficulty in emptying the bladder and an unstable bladder.
Difficulty in emptying the bladder can happen when the sphincter is not relaxed enough to allow the urine out or because the bladder doesn't start to contract when needed. There can also be a problem in maintaining the bladder contraction long enough to ensure that the urine is completely voided.
In any case, a small amount of urine often remains in the bladder which gives the urgent feeling of having to empty the bladder again and again.
Urinary tract infections tend to be common among those who are unable to empty their bladder completely as the urine residue is considered a perfect breeding ground for bacteria.
The unstable bladder is caused when the neural messages from the brain to the bladder are not sent and received properly. When this happens you feel the need to go but try to delay it while you are looking for a toilet. Because the neural message from the brain telling the bladder to "hold on" isn't getting through properly, the person feels a sense of urgency. Should no restroom be found quickly, the person may wet himself. This is also known as urge incontinence.
Bladder problems often become worse during the night as sufferers of Parkinsonism often have reduced dopamine levels at this time of day. This reduced level of dopamine makes it harder for the patient to get out of the bed, walk to the toilet, and begin the process of emptying the bladder. It is not uncommon for people with Parkinsonism to have sleepless nights caused by these frequent visits to the bathroom.
By Jeremy Parker
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