What are treatment options for urinary incontinence following middle cerebral artery (MCA) stroke?

Updated: Feb 20, 2018
  • Author: Daniel I Slater, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Optimal management of poststroke urinary incontinence should be a high priority for the interdisciplinary rehabilitation team. Urinary incontinence is observed in approximately 44-69% of patient’s after stroke. [36, 37, 38] Numerous studies have demonstrated that poststroke urinary incontinence is associated with increased mortality and disability in the acute, postacute, and chronic phase of stroke recovery. [39, 40, 41] The presence of urinary incontinence in this population is also a major factor that determines a patient’s discharge disposition. [42] Poststroke urinary incontinence is associated with increased incidence of depression, [43] caregiver burden, [44] risk of falling, [45] and decline in self-reported quality of life. [46]

As the cause of urinary incontinence in stroke survivors is multifactorial, management strategies must be tailored to the individual needs of the patient. Significant consideration should be given to the possible mechanisms for urinary incontinence, including the assessment of premorbid incontinence. Currently, no evidence supports a single optimal treatment regimen for the management of poststroke urinary incontinence. [47] Bladder management methods that are successful in the nonstroke population are often used in the management of stroke patients. Currently, poststroke urinary incontinence is managed with behavioral, pharmacological, and surgical interventions. [48, 49]


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