Incontinence means you leak urine (wee) or bowel motions (poo) when you do not mean to. It can happen with or without warning.

In Parkinson’s, incontinence is a common non-motor symptom. It can happen because changes in the brain and autonomic nervous system affect how your bladder and bowel “get the message” to store and empty.

How common is it?

Urinary symptoms are common in Parkinson’s. A large systematic review found:

  • About 6 in 10 people with Parkinson’s have lower urinary tract symptoms (such as urgency, frequency, or nocturia).
  • About 3 in 10 experience urinary incontinence.
  • Nocturia (waking at night to wee) affects about 6 in 10.

Why it can happen (and why it can vary day to day)

In young onset Parkinson’s, bladder and bowel symptoms can be made worse by:

  • Medication timing, including “wearing off”, which can increase urgency or make it harder to get to the toilet in time.
  • Mobility changes, including stiffness, slowness, or freezing, which can cause “functional incontinence” (you cannot get there fast enough).
  • Constipation, which can press on the bladder and worsen urgency or leakage.

How do you know if you have incontinence?

You do not need a major accident for it to “count”. Small leaks matter.

Common signs of incontinence include:

  • You leak on the way to the toilet.
  • You get a sudden, strong urge that is hard to hold.
  • You wee often, including passing small amounts.
  • You wake more than once a night to wee.
  • You feel you cannot fully empty your bladder.
  • You have constipation and notice bowel leakage around hard stool.

A simple self-check (this week):

  • Track 3 days of drinks, toilet visits, urgency episodes, and any leaks. A diary is a standard part of assessment and can speed up help if you complete one before you attend your appointment.

Types of incontinence you might notice

You may have one type or a mix:

  • Urge incontinence: you get a sudden urge and leak before you reach the toilet.
  • Nocturia: you wake at night to wee.
  • Urinary frequency: you wee often, sometimes with small amounts.
  • Overactive bladder: urgency and frequency, with or without leakage.
  • Urinary retention: trouble starting or fully emptying.
  • Functional incontinence: slowed movement or gait changes, or clothing that gets in the way of getting to the toilet in time.

What you can do now

1) Raise it early with your GP or neurologist

Ask for a bladder/bowel review, including:

  • Medication timing and “wearing off” patterns.
  • A check for other causes (for example, urinary tract infection, prostate issues, pelvic organ prolapse).

2) Ask for the right referral

Many people do best with targeted support, such as:

  • A continence nurse.
  • A pelvic health physiotherapist for pelvic floor and urge control training.
  • A neuro-urologist.

3) Use bladder training (not “just live with it”)

Bladder training is a structured approach that builds control over urgency and frequency. A randomised controlled trial in Parkinson’s found bladder training improved people’s sense of improvement and reduced daily voids compared with conservative advice alone.

What bladder training often includes:

  • Urge suppression and distraction techniques.
  • Pelvic floor exercises (taught correctly).
  • A planned voiding schedule that changes over time.

4) Manage constipation as part of bladder care

Constipation can worsen bladder symptoms. Conservative advice in Parkinson’s bladder training trials includes constipation management for a reason.

If you are constipated, raise it early with your GP. Do not keep adding fibre if it makes you feel more blocked.

5) Review drinks without dehydrating yourself

Hydration matters. Many people cut fluids too hard and end up with concentrated urine that irritates the bladder. Conservative advice commonly includes reducing bladder irritants such as caffeine and alcohol. Stay hydrated.

A useful pattern for nocturia (frequent nighttime urination that disrupts sleep, often caused by fluid retention during the day and reabsorption when lying down) is to drink more earlier in the day and reduce fluids closer to bedtime.

Tricks & “life hacks” that can help in the moment

These are practical tools you can trial alongside clinical care.

Urge “pause plan” (30–60 seconds)

When urgency hits:

  1. Stop moving if you can (rushing can make urgency spike).
  2. Breathe slowly and drop your shoulders.
  3. Do 3–5 quick pelvic floor squeezes, then relax. (A pelvic health physio can teach the right technique.)
  4. Use distraction: count backwards, name suburbs, scratch the back of your knee or do simple mental maths.

Latchkey incontinence (key-in-the-door urgency)

Some people leak when they get home or put the key in the door. This is called latchkey incontinence or situational urgency urinary incontinence. It is linked to learned cues and can improve with targeted strategies.

What can help:

  • Change the routine: before unlocking the door, stop, breathe, and do your urge “pause plan”.
  • Break the cue: swap hands for the key, unlock the door more slowly, or pause for 10 seconds before entering.
  • Mindfulness approaches: a randomised pilot study found mindfulness and/or non-invasive brain stimulation reduced leaks and urgency linked to situational triggers in women.

YOPX tip: Some people find that lightly scratching behind the knee while unlocking the door helps distract the brain long enough to get inside.

Incontinence-friendly clothes & emergency kit

  • Choose clothes that are quick to undo (elastic waists, simple fastenings).
  • Keep a small kit in your bag or car: spare underwear, wipes, zip-lock bag, and a travel change of clothes.
  • Use night lighting and clear pathways to reduce falls risk when you rush at nighttime.

When to get urgent medical help

Get same-day medical advice if you have:

  • Pain or burning when you wee, fever, or you feel unwell (possible infection).
  • Blood in urine.
  • You cannot wee at all, or you have severe lower abdominal pain (possible retention).

Support in Australia

  • National Continence Helpline (1800 330 066): staffed by continence nurse advisers, available to anyone in Australia.
  • National Public Toilet Map: find public toilets across Australia. toiletmap.gov.au
  • MLAK key (Master Locksmiths Access Key): supports 24/7 access to some locked accessible toilets and facilities. masterlocksmiths.com.au

What we recommend you do next

  1. Start a 3-day bladder/bowel diary.
  2. Book a GP appointment and take the diary. Ask about medication timing, constipation, possible UTI, and any specialist referrals.
  3. Contact the National Continence Helpline if you want advice before your appointment.

References

Information adapted from https://www.parkinsons.org.au/information-hub/incontinence/

Anis, O., Anis, S., Reed, M. M., Teixeira-dos-Santos, D., Ivary, S., Trump, T., & Goldman, H. B. (2025). Urologic symptom management in Parkinson’s: Current treatments and emerging directions (Systematic review). Current Urology Reports, 26, Article 77. https://doi.org/10.1007/s11934-025-01297-x

Australian Government Department of Health, Disability and Ageing. (2025, November 25). National Continence Helpline. https://www.health.gov.au/contacts/national-continence-helpline

Conklin, C. A., Coffman, B., Greco, C. M., Tyagi, S., & Clarkson, B. D. (2025). Mindfulness and transcranial direct current stimulation (tDCS) to attenuate situational urgency urinary incontinence (UUI): A randomized pilot study. Continence, 14, 101765.

Continence Health Australia. (n.d.). National Continence Helpline (1800 33 00 66). https://www.continence.org.au/get-support/who-can-help/national-continence-helpline

Li, F.-F., Cui, Y.-S., Yan, R., Cao, S.-S., & Feng, T. (2022). Prevalence of lower urinary tract symptoms, urinary incontinence and retention in Parkinson’s: A systematic review and meta-analysis. Frontiers in Aging Neuroscience, 14, 977572. https://doi.org/10.3389/fnagi.2022.977572

McDonald, C., Rees, J., Winge, K., Newton, J. L., & Burn, D. J. (2020). Bladder training for urinary tract symptoms in Parkinson’s: A randomized controlled trial. Neurology, 94, e1427–e1433. https://doi.org/10.1212/WNL.0000000000008931

Master Locksmiths Association of Australasia. (n.d.). Master Locksmiths Access Key (MLAK). https://masterlocksmiths.com.au/mlak/

National Public Toilet Map. (n.d.). National Public Toilet Map. https://toiletmap.gov.au/

Yeo, L., Singh, R., Gundeti, M., Barua, J. M., & Masood, J. (2012). Urinary tract dysfunction in Parkinson’s: A review. International Urology and Nephrology, 44, 415–424. https://doi.org/10.1007/s11255-011-9969-y

Cleveland Clinic. (2025, January 31). Understanding latchkey incontinence. https://health.clevelandclinic.org/latchkey-incontinence

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