From the Research
Approximately 40-60% of patients with major stroke require urological follow-up in the acute phase, as urinary incontinence can affect a significant proportion of people admitted to hospital after a stroke. This high percentage reflects the common occurrence of urinary complications following stroke, particularly urinary retention and incontinence. These complications arise because stroke often affects the neural pathways controlling bladder function, disrupting normal urination patterns. Urological follow-up typically involves assessment of post-void residual volumes, management of urinary retention (which may require intermittent catheterization), treatment of urinary tract infections, and addressing incontinence issues. Early urological intervention is crucial as untreated urinary complications can lead to infections, kidney damage, and prolonged hospital stays. The specific approach depends on the severity of urological symptoms, with some patients requiring only temporary intervention while others may need long-term management strategies. Prompt recognition and management of these issues significantly improves patient outcomes and quality of life during stroke recovery, as supported by a recent review of interventions for treating urinary incontinence after stroke in adults 1.
Some key factors to consider in the management of urinary incontinence after stroke include the type and location of the stroke, cognitive status, upper limb function, and the presence of comorbidities or medications that may exacerbate incontinence 2. Additionally, the use of indwelling urinary catheters should be carefully managed to reduce the risk of catheter-associated urinary tract infections, as highlighted in a recent study on the effectiveness and safety of a program for appropriate urinary catheter use in stroke care 3.
Overall, the management of urinary incontinence after stroke requires a comprehensive approach that takes into account the individual patient's needs and risk factors, with the goal of improving outcomes and quality of life. The most recent and highest quality evidence suggests that approximately 40-60% of patients with major stroke require urological follow-up in the acute phase 1.
Key considerations in the management of urinary incontinence after stroke include:
- Assessment of post-void residual volumes and management of urinary retention
- Treatment of urinary tract infections and addressing incontinence issues
- Careful management of indwelling urinary catheters to reduce the risk of catheter-associated urinary tract infections
- Consideration of the type and location of the stroke, cognitive status, upper limb function, and the presence of comorbidities or medications that may exacerbate incontinence.