From the Research
Approximately 15% of patients with major stroke require urological follow-up in the chronic phase of stroke. This follow-up is primarily needed for patients who develop persistent urinary incontinence, retention, or recurrent urinary tract infections after the acute phase has passed. Post-stroke urological issues often result from neurological damage affecting bladder control pathways, with damage to the frontal lobe or pontine micturition center being particularly significant. Management typically involves a combination of approaches including:
- Timed voiding
- Pelvic floor exercises
- Medications such as anticholinergics (oxybutynin 5mg 2-3 times daily or tolterodine 2-4mg daily) for overactive bladder, or alpha-blockers (tamsulosin 0.4mg daily) for retention issues Patients may also benefit from intermittent catheterization if retention is significant. Early identification and treatment of these issues is crucial as they significantly impact rehabilitation outcomes, quality of life, and can lead to complications like urinary tract infections or skin breakdown if left untreated 1. The most recent and highest quality study suggests that interventions for treating urinary incontinence after stroke in adults are not well established, and more research is needed to provide robust evidence for interventions to improve urinary incontinence after stroke 1.