Urinary incontinence (UI) is the loss of control of urine, or the inability to hold urine in until a bathroom can be reached. Unfortunately, UI following a stroke is common. The prevalence ranges from 37% to 79% in the days and weeks following the stroke. While many individuals with stroke will regain control of their bladder, one-third will remain incontinent at one year post-stroke.
There are multiple etiologies for UI post-stroke. UI may result from infarction or cerebral edema affecting central micturition pathways. Alternatively, impairments of consciousness; cognitive or language difficulties and motor and sensory loss, can also affect toileting, despite normal bladder function. Frequent coughing in individuals who experience dysphagia post-stroke may also exacerbate UI. In addition, certain medications; depression; constipation; pre-morbid conditions such as peripheral neuropathies from diabetes; pre-existing UI and environmental factors that impede toileting - or a combination of these - will increase the likelihood of UI post-stroke.
In most cases, UI can be treated successfully. Management of UI takes many forms including behavioural, pharmacological, surgical and supportive devices. The present review focuses on the behavioural management, the first line treatment for UI secondary to bladder dysfunction. Specific behavioural intervention for UI include:
Authors*: Chantal Dumoulin, PhD PT; Nicol Korner-Bitensky, PhD