Urinary Incontinence after Stroke

Urinary Incontinence is seen in almost 60% of people after they experience a stroke. However, it is only a temporary problem in most of the people. Usually, recovery takes place before the patient is discharged from the hospital. Stroke may or may not lead to urinary incontinence, and many treatment options are available.

Stroke or Cerebrovascular Accident (CVA)
The brain needs oxygen to function properly, and this is supplied by the blood flowing through it. When the blood supply to a part of the brain is disturbed, stroke occurs. If the brain does not get enough oxygen, the cells will die. As the brain cells regulate and carry out all other functions of the body, any disturbance in its function will lead to other serious problems. Apart from urinary incontinence, people affected by stroke may also exhibit difficulty in talking, swallowing, and moving the limbs. The part of the body affected entirely depends on the part of the brain involved.

Cause of Urinary Incontinence after Stroke
Urinary incontinence occurs when the anterior cerebral artery is occluded. This artery supplies the anterior part of the brain including the frontal lobe. Any disturbance in the supply of blood to this part may result in urinary incontinence.

Patients with urinary incontinence will not be able to empty the bladder voluntarily. This is because such people will not be able to sense that the bladder is full. In some cases, dribbling occurs when the bladder is full. When the anterior cerebral artery is affected, it may also result in weakness or paralysis of the lower limbs on one side, aphasia, change in behavior, and grasp reflex on one side of the body. As the lower limbs are affected, the patient will not be able to walk to the toilet, and may not be able to hold urine for a long time due to incontinence.

The type of treatment needed will depend on the severity of the condition. If not treated early, urinary incontinence will lead to retention of urine in the bladder, which may result in urinary infections.

One of the treatment methods used is behavioral therapy. In this method, the patient is encouraged to urinate at regular times. For this, the bladder is trained and fluid intake is managed.

Another treatment option is physical therapy. Pelvic-floor muscle exercises will improve the strength of the muscles which will in turn help in voluntary control of urination.

The doctor may also prescribe anticholinergic medicine, which will reduce the frequency of urination. Apart from that, topical estrogen and imipramine may also be prescribed.

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