
A stroke can cause damage to the brain, which may lead to an inability to urinate. This is called urinary retention. It can also cause urinary incontinence, which is the inability to control urination. Urinary incontinence affects up to 25% of stroke survivors within the first year post-stroke, and up to 15% still experience it a year or more post-stroke.
Characteristics | Values |
---|---|
--- | --- |
Number of participants continent after treatment | 453 per 1000 |
Number of incontinent episodes | 1.2 |
Perception of improvement or cure | N/A |
Health status and quality of life | -0.91 |
What You'll Learn
- Incontinence is common after a stroke
- It can be caused by physical, communication, and vision changes
- Types of incontinence include frequency, functional incontinence, urge incontinence, urinary retention, nocturnal incontinence, and faecal incontinence
- Treatments include pelvic floor exercises, medication, and bladder training
- Incontinence can also be caused by changes to diet and medication
Incontinence is common after a stroke
Incontinence is a common complication after a stroke, affecting nearly half of all acute stroke survivors. This is because a stroke can alter the ability to effectively control the muscles involved with bowel and bladder functions. Urinary incontinence affects up to 25% of stroke survivors within the first year post-stroke, with 15% still experiencing it a year or more after their stroke.
Incontinence can be defined as an involuntary loss of urine from the bladder (urinary incontinence) or the uncontrolled passing of faeces (faecal incontinence). Urinary incontinence is more prevalent than faecal incontinence, although some survivors experience both.
There are many types of incontinence a survivor may experience following a stroke, with some survivors experiencing more than one. It’s important to remember that constipation, diarrhoea, and urinary retention are all common following a stroke and may increase urge and functional incontinence issues.
For some stroke survivors, incontinence may be a consequence of the damaged brain tissue suffered from a stroke. This tissue damage can cause muscular spasms, loss of sphincter control, and other impairments. Those struggling with cognitive difficulties may not be able to communicate their need to use the restroom in time, causing delays and potential accidents. Motor impairments are common after a stroke, which can increase the amount of time an individual needs to reach the bathroom and adjust their clothing.
There are many proven strategies to help individuals regain control and minimise accidents. These include:
- Wardrobe modifications, such as switching to pants with an elastic waistband for convenience.
- Home modifications to ensure the person can easily and quickly reach the restroom unhindered.
- Bedpans and portable urinals can be strategically and discreetly placed in rooms to minimise accidents.
- Adult diapers are a solid backup plan, especially if the survivor has some room to go in the recovery journey before being able to manage using the bathroom independently.
- Making small changes to a person’s diet and feeding schedule, such as minimising fluid intake in the hours leading up to bedtime.
- Establishing set times for bathroom breaks staggered throughout the day, or timed voiding. Once a comfortable routine has been established, the space between these scheduled breaks can be increased.
- There are also exercises designed to strengthen the muscles of the pelvic floor, which can help survivors struggling with urinary stress incontinence and bowel incontinence.
- If exercises and lifestyle adjustments have failed to address a survivor's incontinence issues, their doctor may recommend the use of medications for constipation or incontinence.
Understanding Strokes: Meaning, Causes, and Effects
You may want to see also
It can be caused by physical, communication, and vision changes
A stroke can cause physical, communication, and vision changes, which in turn can lead to an inability to urinate.
Physical Changes
Physical changes after a stroke depend on which part of the brain was affected. Some common physical changes include:
- Weakness or paralysis of limbs on one side of the body.
- Restricted physical abilities and difficulty with gripping or holding things.
- Fatigue or tiredness, which can be caused by physical changes, medication, mood changes, depression, anxiety, or sleep disturbances.
- Incontinence, which can be caused by medication, muscle weakness, or changes in sensations, thinking, and memory.
- Pain, which can be caused by damage to tissues or nerves sending incorrect messages to the brain.
Communication Changes
About 1 in 3 people who've had a stroke have some trouble with language, including talking, understanding speech, reading, or writing. Communication problems after a stroke often improve with time and treatment, and can include:
- Aphasia, which affects how people process language in their brains. Some people with aphasia can understand language but can't speak, while others can talk but don't make sense.
- Dysarthria, which is when a person can't speak clearly and slurs their words, and may have trouble speaking with a normal tone, too softly, or too slowly.
- Apraxia of speech, where the person struggles to say words correctly because they can't get their tongue or lips to work properly.
Vision Changes
Vision is the brain's process of gaining meaning from what we see. A stroke may cause vision loss, with about 65% of survivors experiencing vision problems. Vision complications depend on where in the brain the stroke occurred. For example, a stroke in the occipital lobe can cause a loss of vision in the right or left half of the visual field in each eye (homonymous hemianopia). A stroke in the brain stem can affect eye movements, sensations related to balance and stability, and the ability to recognize and understand objects.
How These Changes Can Lead to Urinary Issues
Urination is a complex process that requires coordination between the brain, spinal cord, and nerves. As a stroke can cause issues with coordination and overall brain function, it can lead to urinary incontinence or retention. Urinary incontinence is the inability to control urination, while retention means a person cannot completely empty their bladder or urinate when they want to. These issues can cause discomfort, leaking, and bladder infections, which can have serious health consequences if left untreated.
Managing Temper Tantrums in Stroke Patients
You may want to see also
Types of incontinence include frequency, functional incontinence, urge incontinence, urinary retention, nocturnal incontinence, and faecal incontinence
Types of Incontinence
Frequency
Frequency is characterised by the need to pass urine more often than usual.
Functional Incontinence
Functional incontinence is caused by trouble getting to the toilet on time or at all. This could be due to physical disabilities or difficulties in communicating the need to use the toilet.
Urge Incontinence
Urge incontinence is a sudden and uncontrollable need to pass urine, which may result in wetting oneself. It is caused by detrusor overactivity, which is when the bladder muscle begins to contract and signals a need to urinate, even when the bladder is not full.
Urinary Retention
Urinary retention, also referred to as bladder retention, means that you may not be able to completely empty your bladder or you may not be able to urinate when you want to. This can be bothersome and uncomfortable, and can also lead to serious health problems such as urinary tract infections.
Nocturnal Incontinence
Nocturnal incontinence is the need to go to the toilet several times during the night.
Faecal Incontinence
Faecal incontinence is the uncontrolled bowel movement, resulting in soiled underwear. It can be caused by damage to the part of the brain controlling the bowel, not being able to get to the toilet in time, or having diarrhoea or constipation.
Pulmonary Stress Test: Stroke Risk and Complications
You may want to see also
Treatments include pelvic floor exercises, medication, and bladder training
Treatments for urinary incontinence after a stroke include pelvic floor exercises, medication, and bladder training.
Pelvic floor exercises, also known as Kegel exercises, involve contracting and relaxing the muscles used to stop the flow of urine. These exercises can help strengthen the muscles involved in urination and improve bladder control.
Medications used to treat urinary incontinence include anticholinergics, adrenergics, and hormonal treatments. Anticholinergic drugs, such as oxybutynin, can help reduce the frequency of involuntary urine leakage by decreasing bladder spasms. Adrenergic agonists can promote continence by affecting the contraction strength of the bladder neck and urethral sphincter muscle. Hormonal treatments, such as estrogen therapy, can be prescribed for postmenopausal women to help maintain a healthy bladder and urethra.
Bladder training involves learning to delay urination and gradually increasing the time between bathroom visits. This technique helps improve bladder control and reduce the frequency of urination. It is often combined with other treatments, such as pelvic floor exercises, to enhance their effectiveness.
These treatments can help improve bladder control and reduce the impact of urinary incontinence on daily life. However, the effectiveness of these treatments may vary from person to person, and it is important to consult a healthcare professional for personalized advice and guidance.
Stroke Patients and Consent: California Law Explained
You may want to see also
Incontinence can also be caused by changes to diet and medication
Incontinence can be caused by changes to diet and medication. Certain medications can affect bladder and bowel control. For instance, some blood pressure medications can affect bladder control or cause constipation. It is important to ask your pharmacist or healthcare provider about the side effects of any medications you are taking. Do not stop taking any medication before speaking to your doctor.
A diet that is high in fibre and fluids can help to regulate the bowel and keep stools at the right consistency, avoiding constipation. It is recommended to drink 6-8 glasses of water per day and limit or avoid caffeine, fizzy drinks, and alcohol, as these can irritate the bladder.
If you are experiencing incontinence, a dietitian can help you adjust your diet to include the right balance of fibre and fluid. They may recommend that you increase your fibre intake and adjust your fluid intake accordingly.
It is also important to note that incontinence can be treated, managed, and cured. The first step is a full assessment by health professionals, who will work with you to develop a plan to manage and improve your incontinence.
Stroking Foxes: Is It Safe?
You may want to see also
Frequently asked questions
An overactive bladder is a condition where the bladder muscles contract suddenly and involuntarily, causing a sudden urge to urinate. This can lead to urine leakage.
A stroke can cause damage to the parts of the brain that control the bladder, leading to an overactive bladder.
Treatment options for an overactive bladder include medication, physical therapy, and lifestyle changes.