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Arch Hellen Med, 27(2), March-April 2010, 180-186


Urinary incontinence associated with cerebrovascular accident

National Institute of Rehabilitation, Ilion Greece

Urinary incontinence in the acute stage of stroke is an important measure of stroke severity and the size of the infarct or cerebral hemorrhage. Urinary incontinence is seen as a predictor of death or severe disability, and it is an important factor for hospital discharge destination. It affects the rehabilitation of stroke survivors and their quality of life, but also that of caregivers. Daily incontinence, caused not only by stroke, is common, affecting 1 in 20 persons aged under 65 years, increasing to 1 in 12 in those over 75 years of age. The prevalence increases still further in the physically impaired. Urinary incontinence therefore will commonly occur in stroke survivors as a consequence of their disability. It is likely, also, that stroke will occur in some previously incontinent persons, and a close association between stroke and incontinence has been demonstrated. A population census in the United States reported that 36% of persons aged 65 years and over had moderate difficulty in holding their urine and that this difficulty was correlated with stroke. The prevalence of urinary incontinence in stroke survivors is between 57-83%. Incontinence is often temporary and is related to cognitive impairment and functional disability. There is an association between urinary incontinence and neurological lesions in regions that are related to the control of micturition. Urodynamic evaluation usually reveals detrusor overactivity. Normal function or detrusor underactivity has also been reported. To remain continent a person must be able to appreciate the need to void, to communicate that need, to be motivated, be able to be transferred to a toilet, to delay voiding until the appropriate time, and to initiate voluntary voiding. Urinary incontinence is stressful for caregivers of incontinent stroke survivors. The place of discharge is related to incontinence, which affects the ability of the stroke survivor to take care of him/herself, reduces self-confidence and affects rehabilitation.

Key words: Cerebrovascular accident, Stroke, Urinary incontinence.

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