This seems to be a frequent complaint of the members of this
group. The causes are many. My first choice would be infection
- bladder or prostate. Usually responds to treatment.
Obstruction: Bladder outlet or prostate which causes
poor emptying and thus more frequent filling with a more frequent urge to
void. Voided volumn may be small. The end result is that the bladder
doesn't empty well. This is usually initially treated with a slective
alpha blocker (Hytrin, Cardura, Flomax) Proscar can be used in
addition if the prostate is very large. If medical management doesn't
help then some type of operative proceedure may be needed.
(TURP or other endoscopic methods which treat the prostate with heat
energy, microwaves etc.
Medicatiions may cause the bladder to work less effectively.
Behaves much like obstruction with poor emptying and thus frequency. Any
medication with anticholinergic actions may cause this. But these
medications are used to treat the next catagory - neurogenic causes. Medications
often used to treat PD are in this catagory. Don't forget that many
antihypertensive have a diuretic component.
Neurogenic instability can lead to poor bladder emptying and
or urinary frequency (frequency with or without poor emptying. Detrol,
Ditropan, or ProBanthine are often used for this problem. (see medications
above). Voiding is a very complex and coordinated function. Muscles
must contract while others must relax. Anything which upsets this delicate
balance causes problems voiding. This may also be a natural function of
PD. We slow down and it is more difficult to get to the bathroom, manage
our clothes etc.
There are some causes of urinary frequency which we often
forget about. As we age we lose our diurnal urinary variation. i.e. we do
more in the day than at night. Our night time volumn wil increase causing
frequency at night. During the daytime when we are up and about we tend to
pool fluid in our lower extremities. It may or may not be visable as edema
but this fluid is mobilized at night and our kidney's say 'where did all this
come from' and make an increased volumn at night.
The basic outcome is that we have a number of reasons to have
urinary frequency, urgency, and/or incontinence. They range from a normal
physiologic response to aging, diseases of the urinary system, neurologic
causees and/or medications. There isn't an easy way to sort it out.
Start with your primary care physician and work toward a Urologist.
Hope my ramblings are helpful.
My best,
Ira
Retired with PD
