Why is there a High Prevalence of Incontinence in Stroke Patients?

Sadly, half of all people admitted to hospital with a stroke will have lost control over their bladder. Incontinence in stroke patients can severely affect their quality of life and be a life-changing condition.

Stroke is the major cause of severe chronic disability in the UK, accounting for 4% of the total National Health Service budget, with stroke patients occupying approximately 12% of beds on general medical wards and 12% of stroke survivors. Understanding the link between a Stroke and incontinence can help improve the care people are provided with.

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A recent study focused on 151 patients who had experienced a stroke to determine the occurrence and outcome of incontinence after a stroke. At 1 week, 60% of patients of the survivors were not continent. This was the case in 42% of the patients at 4 weeks and 29% of patients at 12 weeks. These shocking statistics emphasize the high prevalence of incontinence in Stroke patients. Unfortunately, as incontinence is still often viewed as a taboo topic, individuals suffering from incontinence are unlikely to talk about their problem. This means that even more people than we think may have incontinence after a Stroke.

Why a Stroke Causes Incontinence: Explaining the Link..

A number of recent studies have linked the presence of incontinence in stroke survivors to various neurological lesions in areas thought to be primarily involved in micturition. Neurological deficits caused by a stroke may also affect the management of bladder control by apraxia or aphasia. A stroke can affect the part of the brain responsible for controlling your bladder and bowel. Nerve pathways controlling bladder can be damaged due to a Stroke. If you have lost control over the muscles in your bladder and bowel, you may wet or soil yourself without realizing it. Lack of control over your movement and actions may mean you are not always able to get there in time. Physical disabilities can also make it difficult to reach the toilet unaided, which can make sitting and standing painful.

Incontinence can also be caused due to difficulty with communication, which results in being unable to make yourself understood. Around one-third of stroke survivors have problems with speaking, reading, writing and understanding what other people say to them. There several types of communication difficulties that can cause this; aphasia, dysarthria and apraxia of speech. Aphasia occurs when you are no longer able to understand or use language. Dysarthria occurs when you’re not able to control the muscles in your face, mouth and throat very well, so it’s difficult to speak clearly. Apraxia of speech is when you can’t move the muscles in your face, mouth or throat in the order you need to when you’re speaking.

How is Incontinence after a Stroke Treated?

Physiotherapy and bladder-retraining programs are found to cure or significantly improve incontinence in stroke patients. Individualized strategies for overcoming incontinence can be determined by a healthcare professional conducting an evaluation. Early diagnosis and treatment are important to prevent possible complications such as urinary tract infections or skin breakdown.

There are a number of health professionals who are trained helping people who have incontinence after dealing with a stroke. You should contact the following health professionals for useful guidance and treatment:

Continence advisers. Continence advisers can recommend useful toileting aids and equipment, teach you good bladder and bowel habits and provide exercises and strategies to help. Practising pelvic floor exercises is a popular and effective treatment method for improving incontinence.

Urologists. Urologists have in-depth knowledge of problems of the urinary system and can help to improve your bladder health.

Occupational therapists. You can contact occupational therapists to help you to find the right toilet aids and equipment and provide you with tips on easy clothing. They can also recommend foods and advise you on the right amount of fluid to help you with your bladder and bowel movement.

Speech Pathologists. Speech pathologists are trained to help you to communicate when you need to go to the toilet to avoid leakages.

Physiotherapists. Physiotherapists can help with your walking and how to get to the toilet or on and off a commode. They can also give you exercises to strengthen your pelvic floor muscles. These are the muscles you use when ‘holding on’ before going to the toilet.

A Doctor or GP with knowledge of incontinence treatment can change any medications that could be making your incontinence worse.

Incontinence following a Stroke is unpleasant to manage and can have an effect on your quality of life. However, if you are willing to find a perfect method of treatment, it becomes much easier to manage.