From the Research
Hyperparathyroidism and urinary incontinence are two separate conditions that should be treated independently, with hyperparathyroidism typically addressed through surgery or medications like cinacalcet, and urinary incontinence treatment depending on the type and may include pelvic floor exercises, bladder training, medications, or surgical interventions. Hyperparathyroidism is a condition where the parathyroid glands produce excessive parathyroid hormone (PTH), leading to increased calcium levels in the blood, which can cause symptoms like bone pain, kidney stones, fatigue, and cognitive issues 1. Urinary incontinence, on the other hand, is the involuntary leakage of urine, typically resulting from weakened pelvic floor muscles, neurological issues, or problems with the urinary tract. While hyperparathyroidism can cause increased urination due to elevated calcium levels (hypercalciuria), this is different from true incontinence.
Some key points to consider in the treatment of hyperparathyroidism include:
- The use of cinacalcet, a positive allosteric modulator of the calcium sensing receptor, which has been shown to lower serum calcium and PTH levels in patients with primary hyperparathyroidism 1.
- The importance of monitoring serum calcium and PTH levels, as well as urinary calcium, to adjust treatment as needed 2, 3.
- The potential for cinacalcet to decrease parathyroid gland volume and serum PTH level, irrespective of the pretreatment parathyroid gland status and past treatment history 4.
In terms of treatment, cinacalcet has been shown to be effective in lowering serum calcium and PTH levels, with a significant reduction in parathyroid gland volume, and is a useful alternative for the treatment of secondary hyperparathyroidism in pre-dialysis patients who are unresponsive to other treatments 2, 1, 4. However, it is essential to note that hyperparathyroidism and urinary incontinence should be treated separately, and consulting with both an endocrinologist for hyperparathyroidism and a urologist or urogynecologist for incontinence would provide the most comprehensive care.
The most recent and highest quality study on this topic, published in 2022, found that cinacalcet lowers serum calcium and PTH with greater effects on calcium than on PTH in the short term, and is safe with tolerable side effects 1. This study provides strong evidence for the use of cinacalcet in the treatment of hyperparathyroidism, and highlights the importance of individualized treatment plans to achieve optimal outcomes.