Behavioral and/or Mirabegron to Treat Urinary Symptoms in Parkinson Disease

Inclusion Criteria: * Clinical diagnosis of PD determined by a board-certified neurologist with specialty training in movement disorders * An ICIQ-OAB Symptom Score of 7 or higher, which indicates clinically significant symptoms of OAB, defined as presence of urinary urgency with or without urgency incontinence usually with increased daytime frequency and nocturia in the absence of infection or other obvious pathology Exclusion Criteria: * Significant cognitive impairment, as indicated by a Montreal Cognitive Assessment (MoCA) score of \< 18 or a telephone-MoCA score \< 13, which is the recommended diagnostic cut point for dementia in PD. * Previous intensive pelvic floor muscle exercise training * Clinically significant depression as measured by a Geriatric Depression Scale-Short Form score of 10 or higher which could affect motivation to fully engage in the intervention * Use of an indwelling urinary catheter * Post-void residual urine measurement by bladder ultrasound of \> 150 mL * Severe uterine prolapse past the vaginal introitus * Poorly controlled diabetes defined by a hemoglobin A1c (HgbA1c) of \>9.0% within the last 3 months. Participants with poorly controlled diabetes will be offered enrollment if the OAB symptoms persist after improvement in diabetes control * Chronic renal failure and on hemodialysis * Genitourinary cancer with ongoing surgical or external beam radiation treatment * Previous artificial urinary sphincter, sling procedure or implanted sacral ne…