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Urinary Incontinence After Stroke

Post-stroke urinary incontinence is a common and complex issue. Although for many stroke survivors incontinence resolves itself in the weeks following the stroke, that's not always the case. According to a study by Southern Illinois University School of Medicine there are three major causes of incontinence after an acute stroke:

1) Disruption of neural pathways, resulting in bladder hyperreflexia and urgency incontinence
2) Incontinence due to stroke-related cognitive and language deficits (like aphasia), with normal bladder function
3) Concurrent neuropathy (a collection of disorders resulting from damage to the nervous system) or medication use, resulting in bladder hyporeflexia and overflow incontinence

Resolving urinary incontinence is important; the condition can leave stroke survivors feeling anxious, socially isolated, and depressed. It also creates a burden for caregivers that can make home-care a struggle. The good news is that there are multiple therapies to help improve urinary function for survivors.

Drug therapies.  Doctors can prescribe drugs that increase urine retention, such as Levitrin, Ditropan, and Cystospaz.
 

Drug monitoring. Certain prescription drugs that are commonly used by stroke survivors can cause or aggravate urinary incontinence. High blood pressure drugs such as alpha blockers can relax the bladder and make accidents more likely. Certain antidepressants can make it hard for the bladder to contract and fully empty. Diuretics that reduce blood pressure increase urine production.

Prompted voiding. By scheduling, reminding, and assisting patients with urination, the number of accidents can be reduced.
Pelvic floor training. In women, Kegel exercises have proven extremely effective in improving urinary incontinence, with 50-75% of patients having  substantial improvements.
 

Bladder training. By creating a specific, graduated schedule for urinating, patients can gradually increase the time between urination, starting with short intervals and progressing to 3–4 hours between
 

Behavioral therapy. In a study published by the Journal of American Medical Association, women who kept a diary of their urinary habits and were taught exercise techniques, muscle control and relaxation techniques had an average reduction of incontinent episodes of 81%—significantly higher than the drug and placebo groups.

By: Stroke-Network.com Staff Writer

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"Resolving urinary incontinence is important; the condition can leave survivors feeling anxious, socially isolated, and depressed. It also creates a burden for caregivers that can make home-care a struggle. T"

According to a study by Southern Illinois University School of Medicine there are three major causes of incontinence after an acute stroke:

1) Disruption of neural pathways, resulting in bladder hyperreflexia and urgency incontinence
2) Incontinence due to stroke-related cognitive and language deficits (like aphasia), with normal bladder function
3) Concurrent neuropathy (a collection of disorders resulting from damage to the nervous system) or medication use, resulting in bladder hyporeflexia and overflow incontinence