Common urinary issues that can occur in MS, Parkinson’s and Stroke

• Urgency/Over- active bladder (an urgency to void and difficulty deferring urge)
• Frequency (voiding more than 5 – 6 times day)
• Nocturia (voiding two or more times overnight)
• Urinary Retention due to an inability to empty bladder fully
• Functional Incontinence due to physical restrictions

Common in all three conditions, urine can become concentrated as the bladder is not emptied regularly or properly, further exacerbating the urge to urinate causing bladder irritation.

Usually, the first urinary symptom in Parkinson’s disease, nocturia can occur due to hypertension and fluid retention, and due to an inability to fully empty the bladder during the day (less common in MS and stroke).

Urinary retention can occur in all of these conditions, but is most common in MS as the disease progresses. It occurs when the nerves that carry messages between the brain and bladder no longer work (Neurogenic Bladder). Retention can also occur when muscle tone reduces making emptying the bladder more difficult. (Urinary retention can also occur with a stroke and Parkinson’s- but less common)

Functional incontinence can affect all three of these diseases at various stages, and is due to physical limitations that make it difficult to:

• Reach the toilet on time
• Remove clothing
• Remembering where the toilet is or why looked for it (if cognition an issue)

Individuals may be independent or need:

• mild direction/supervision with toileting
• help getting to or on the toilet
• adjustment of clothing
• perineal hygiene
• placement/removal of pad/liner

The individual may have some difficulty handling some activities related to managing incontinence, due to physical changes to body- reduced strength, sensation, movement or dexterity.

Mild cognitive changes may become evident such as mild memory impairment, some altered problem- solving ability, reduced retention of information

Assistance will change from supervision to partial or full physical assistance as diseases progresses.

• Reduced sensation of urination
• Straining to void or open bowels
• Incomplete emptying of bladder or bowels
• Signs of chronic constipation or faecal impaction
• Urine can become concentrated as bladder not emptied regularly or properly

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