How to treat urinary incontinence in Parkinson disease?

Condition analysis:
Your father shouldn't drink any fluids for two hours before he goes to bed. Additionally, caffeine -- which is in cola, unless it's caffeine-free -- can make incontinence worse. Alcohol is also a diuretic (meaning it increases the production of urine), so drinking beer will make the problem worse.

Your father should ideally have his incontinence evaluated by a urologist or a geriatrician. The two most common types of incontinence are urge incontinence and stress incontinence. In urge incontinence, there's the urge to urinate and an inability to control the bladder. In stress incontinence, increased pressure in the abdomen -- due to sudden movements, laughing, sneezing, and coughing, for example -- cause urine to leak.

Because your father has Parkinson's disease (a movement disorder), it sounds like his incontinence is due to immobility -- meaning he can't make it to the bathroom in time -- rather than a bladder problem.

If your father is drinking a lot of fluids (especially diuretic fluids) just before bed, he'll likely wake up in the middle of the night and need to use the bathroom. If this is the case, you might want to consider getting him a bedside commode if he doesn't already have one. In the later stages of Parkinson's, a loss of inhibition regarding relieving oneself is also common.

You should take a look at the medicines your father is taking as well. Is he using medications advertised directly to the consumer -- such as Flomax or Detrol -- that might be interacting with his Parkinson's medications?

In today's world, people are bombarded with advertisements saying "Here's a way to fix your bladder problem." But consumers need to understand that drugs interact with each other. Certain people shouldn't take certain drugs. Again, talk to your father's physician, and be very specific in asking about drug interactions with parkinson's medications.

Instructions:
Keep a diary. Maintaining a voiding diary, or uro-log, will create a record of when you urinated and the circumstances surrounding it. The diary should include the time of day of urination or leakage; the type and amount of fluid intake that preceded it; the amount voided in ounces (pharmacies carry measuring devices that fit right inside the toilet bowl); the amount of leakage (small, medium, or large); the activity engaged in when leakage occurred; and whether or not an urge to urinate was present. Keeping such a diary for at least four days, if not a full week, before you see a doctor can help him or her determine what type of incontinence you have and the course of treatment. When you see a doctor, take along a list or the actual bottles of any prescription or over-the-counter medicines you have been taking, because some medications can cause incontinence.