April 11, 2026

@michaelokun

Bladder and sexual symptoms are frequently brain symptoms hiding in plain sight. The nervous system includes the brain, spinal cord and nerves that control how organs function, including urination and sexual response. Sakakibara and colleagues describe in a new paper in Nature Reviews Neurology how urogenital dysfunction is tightly linked to the brain and broader nervous system in neurological disease. Key Points: - The bladder and sexual organs are under both automatic and voluntary brain control, making them unique among body systems. - Brain circuits involving the prefrontal cortex, basal ganglia and brainstem actively regulate storage and voiding, and disruption leads to symptoms like urgency or retention. - Dopamine and other neurotransmitters that are central to disorders like Parkinson’s disease also directly influence bladder control and sexual function. My take: We too frequently think about bladder and sexual dysfunction as local organ problems, however this paper reinforces they can be brain/nervous system network problems. If we miss this connection, we miss early diagnosis, better treatments and a chance to improve quality of life in a meaningful way. Here are 5 points that resonated w/ me: 1- Bladder symptoms may be an early signal of brain disease and should trigger a neurological lens. 2- Sexual dysfunction is tightly linked to brain circuits for emotion, motivation and dopamine signaling. 3- Conditions like Parkinson’s disease, stroke and dementia frequently disrupt these networks leading to urogenital symptoms. 4- Treating the brain and not just the bladder or genital organs may lead to better outcomes for many folks. 5- Health care providers should routinely ask about these symptoms as they are common, underreported and highly treatable. https://www.nature.com/articles/s41582-025-01181-9 #parkinson #fixelinstitute #michaelokun