In patients with PD, LUTS are attributed to lesions of the basal ganglia, which interfere with normal inhibition of voiding by the pontine micturition center
. Reduction in nigrostriatal dopamine (specifically, diminished or absent Dl receptor stimulation) leads to partial or total disconnection of the micturition reflex from voluntary control and, in turn, uninhibited bladder contractions in the presence of negligible volumes of urine (Blackett et al., 2009; Gray, Stem, & Malone-Lee, 1995; Katz & Greenstein, 1989; Ransmayr et al., 2008; Singer, 2005; Singer, Weiner, & Sanchez-Ramos, 1992; Siroky, 2003).
The act of micturition involves a complex interplay between the spinal cord, cerebellum, and the pontine micturition center
. The cerebral cortex can transmit inhibitory signals to suppress bladder wall contractions.