Bladder dysfunction is a common and clinically important non-motor manifestation of Parkinson’s disease (PD). Urinary urgency, frequency, nocturia, and urgency urinary incontinence can substantially impair quality of life and may contribute to sleep disruption, falls, functional dependence, and caregiver burden. Management is challenging because patients with PD are often older and may have constipation, cognitive impairment, autonomic dysfunction, and gait abnormalities that increase the potential adverse effects of pharmacological treatment. Recent evidence has highlighted the role of non-pharmacological treatment. A randomized noninferiority trial published in JAMA Neurology compared behavioral therapy with solifenacin in 77 individuals with PD and overactive bladder symptoms. Both interventions produced clinically meaningful improvement, and behavioral therapy was noninferior to drug therapy at 12 weeks. Dry mouth and falls were more frequently reported with pharmacological treatment. These findings support behavioral therapy as an important treatment option for overactive bladder in PD. A comprehensive approach should include identification of the predominant urinary symptoms, exclusion of reversible causes, assessment of postvoid residual urine when indicated, behavioral interventions, and individualized pharmacological or advanced therapy. Treatment should consider motor function, cognition, constipation, fall risk, comorbidities, and patient preferences.

Keywords: Parkinson’s Disease; Bladder Dysfunction; Overactive Bladder; Urinary Urgency; Nocturia; Urinary Incontinence; Pelvic- Floor Muscle Training; Solifenacin; Behavioral Therapy

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