Urinary Incontinence: A Surprising Consequence Of Strokes

can strokes make you urinate

A stroke can cause damage to the brain, which can, in turn, affect the parts of the brain that control the bladder, leading to an overactive bladder. Urinary incontinence is common in people who experience a stroke, with researchers estimating that up to 80% of stroke survivors develop it. Urinary incontinence can be the result of losing consciousness during a stroke, which can cause a person to soil themselves without realising. It can also be caused by damage to the part of the brain that controls the bladder. Urinary retention can also occur soon after a stroke, causing difficulty in emptying the bladder.

Characteristics Values
Prevalence of incontinence after stroke 40-60% of people admitted to hospital after a stroke
Incontinence at hospital discharge 25% of stroke survivors
Incontinence 1 year after discharge 15% of stroke survivors
Risk factors for incontinence Older age, female sex, speech difficulties, motor weakness, visual field defects, cognitive impairment
Types of incontinence Urinary retention, frequency, urgency, and incontinence
Treatment options Bladder and bowel training, behavioural and physical therapies, medication, pelvic floor muscle training, catheterisation

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Urinary incontinence

There are various treatments available for urinary incontinence, including behavioural interventions such as timed voiding and pelvic floor muscle training, and specialised professional input interventions such as structured assessment and management of care. Complementary therapies such as acupuncture have also been found to be effective in reducing incontinence. Pharmacological treatments and hormonal interventions may also be used, although there is limited evidence for their effectiveness.

It is important to seek treatment for urinary incontinence, as it can impact the patient's quality of life and may lead to further complications such as urinary tract infections or skin breakdown. Treatment options can include bladder and bowel training, behavioural and physical therapies, and medication. In some cases, lifestyle changes such as diet modification and fluid intake adjustment can also help to manage the condition.

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Urinary retention

A stroke can cause neurological damage to the body, and the nerves that control the bladder can also be damaged. This can lead to urinary retention, which is the inability to urinate. Urinary retention can occur when the nerves can no longer properly signal to the bladder.

There are several treatments for urinary retention, including medication and the use of a catheter. A catheter is inserted into the bladder through the urethra to help draw urine out. For bedridden individuals or those unable to move, an indwelling catheter may be prescribed. For others, an intermittent catheter may be used temporarily during recovery.

It is important to seek help from a medical professional if you are experiencing urinary retention, as untreated urinary retention can increase the risk of UTIs, bladder infections, bladder damage, kidney infections, and kidney failure.

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Urinary urgency

There are treatments available for urinary urgency and UI, including:

  • Medication
  • Pelvic floor muscle training, such as Kegel exercises
  • Bladder training, or timed voiding
  • Lifestyle changes, such as limiting fluid intake at certain times
  • Electrical stimulation of the pelvic floor muscles

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Nocturia

The cornerstone of nocturia diagnosis and evaluation is the 24-hour voiding diary. Management strategies, which consist of lifestyle modification, behavioural therapy, and medications, should be offered to all patients with significant nocturia, at least on a trial basis, regardless of whether minimal discomfort is reported initially.

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Overflow incontinence

Causes of Overflow Incontinence

  • Blockages in the urethra due to tumours, urinary stones, scar tissue, infection, or kinks caused by the bladder dropping within the abdomen.
  • Weak bladder muscles that are unable to empty the bladder completely.
  • Nerve injuries or damage from diseases such as diabetes, alcoholism, Parkinson's, multiple sclerosis, back problems, or spina bifida.
  • Medications that affect nerve signals to the bladder, including some anticonvulsants and antidepressants.

Symptoms of Overflow Incontinence

  • Needing to urinate often, but only being able to pass small amounts.
  • Difficulty starting to urinate.
  • Starting and stopping while urinating.
  • Feeling like you still need to urinate even after you've finished.

Diagnosis of Overflow Incontinence

If you are experiencing symptoms of overflow incontinence, it is important to consult a doctor. They will ask questions about your bathroom habits, any leakage, pain, infections, and medical history. They may also perform a physical examination and recommend tests such as a bladder stress test, catheterization, urinalysis, ultrasound, or urodynamic testing.

Treatment of Overflow Incontinence

Treatment for overflow incontinence can include:

  • Medications to shrink an enlarged prostate, such as alpha-adrenergic blockers.
  • Surgery to remove a blockage, such as prostate enlargement.
  • Self-catheterization to empty the bladder completely.
  • Bladder training or timed voiding to prevent the bladder from getting too full.

Frequently asked questions

The symptoms of a stroke-induced urinary problem include urinary retention, frequency, and incontinence.

Treatment options for a stroke-induced urinary problem include medication, pelvic floor exercises, bladder training, and catheterization.

Tips for living with a stroke-induced urinary problem include changing your diet, monitoring your intake, selecting the right clothing, and modifying your home to make the bathroom more accessible.

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