Abstract
Urinary incontinence (UI) is a common and disabling problem after stroke. Clinical practice guidelines have been developed outlining assessment parameters and identifying treatment options for incontinence in adults. Research on UI after stroke reveals the need for interventions to treat urge and stress incontinence as well as manage or prevent urinary retention and overflow incontinence. Strategies need to be tailored to individuals with varying levels of physical and cognitive ability. This article describes the nature of voiding problems after stroke, explores the impact on recovery and life after stroke, and outlines recommendations for evaluating and treating UI based on the continence literature.
IN RECENT YEARS, the notion of urinary incontinence (UI) as an inevitable consequence of aging, of being a woman, or bearing children has been challenged by research demonstrating effective treatment for this common problem. Stroke is a leading cause of serious, long-term disability in the United States. Each year about 730,000 Americans experience a new or recurrent stroke. 1 UI is a common health problem after stroke, with potentially serious consequences for recovery and rehabilitation. About 80% of adults with UI can experience significant improvement or resolution of their symptoms with evaluation and treatment. 2 Effective treatment of UI has the potential to improve participation in rehabilitation and ultimately the outcomes of rehabilitation. 3,4 Stroke survivors and their caregivers have identified a need for practical help with UI to improve long-term outcomes after stroke. 5 After a brief review of epidemiology and clinical course of UI after stroke, this article outlines recommendations for evaluating and treating UI based on the continence literature. The discussion of treatment strategies is limited primarily to behavioral techniques-the first line of treatment.