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The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, peripheral myenteric pathology causing slowed colonic transit (loss of rectal contractions) and central pathology causing weak strain and paradoxical anal sphincter contraction on defecation (PSD, also called as anismus) are responsible for the bowel dysfunction. In addition, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the pelvic organ dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Dietary fibers, laxatives, and \u201cprokinetic\u201d drugs such as serotonergic agonists are used to treat bowel dysfunction in PD. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life.<\/jats:p>","DOI":"10.4061\/2011\/924605","type":"journal-article","created":{"date-parts":[[2011,9,12]],"date-time":"2011-09-12T15:00:48Z","timestamp":1315839648000},"page":"1-21","source":"Crossref","is-referenced-by-count":45,"title":["Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease"],"prefix":"10.1155","volume":"2011","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5803-169X","authenticated-orcid":true,"given":"Ryuji","family":"Sakakibara","sequence":"first","affiliation":[{"name":"Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, 564-1 Shimoshizu, Sakura 285-8741, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Kishi","sequence":"additional","affiliation":[{"name":"Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, 564-1 Shimoshizu, Sakura 285-8741, 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