OVERFLOW INCONTINENCE STROKE TRIAL
OVERFLOW INCONTINENCE STROKE PROFESSIONAL

Incontinence is not just a physical problem, but impacts on what people can do and how they feel. Urinary symptoms had more impact on sleep, daily activities, quality of life, physical discomfort, social life and relationships. Other non‐neurological factors contributing to urinary incontinence, including pre‐morbid continence state, sphincter incompetence and polyuria ( Barrett 2001), are regarded as prevalent in the population of patients with stroke ( Brittain 1998b).īecause of their severity, the symptoms of urinary incontinence are reported to have more of an effect on the lives of stroke survivors, when compared with other groups of people with incontinence ( Brittain 2000b).

functional impairment preventing access) consequence of stroke. It is unclear whether incontinence is a direct (i.e.

However, evidence suggests that the size of the lesion, rather than its location, is more likely to predict urinary incontinence ( Brittain 1999). This is generally the result of detrusor overactivity ( Arunabh 1993), although this may depend on the site of the stroke lesion ( Burney 1996b).ĭamage to the frontal lobe, the area believed to be responsible for control of micturition, has been identified in several studies as associated with urinary dysfunction after stroke. The most likely pattern of incontinence is urinary frequency, urgency (a sudden compelling desire to pass urine which is difficult to defer) and urge incontinence (involuntary leakage) ( Marinkovic 2001). Problems experienced may range from urinary retention to complete incontinence. Other risk factors for urinary incontinence include older age, female sex, speech difficulties, motor weakness, visual field defects or cognitive impairment ( Barrett 2001). The more severe the stroke, the greater is the likelihood of urinary incontinence ( Burney 1996a). Addressing problems with continence whilst the person is still in hospital may prevent long‐term problems for the patient and family. Not all the studies reviewed by Barrett 2001 excluded people with pre‐morbid incontinence, however, so figures presented may include old as well as new cases.

40‐60% of people admitted to hospital after a stroke can have problems with urinary incontinence, with 25% of stroke survivors still having problems on hospital discharge, and 15% remaining incontinent after one year ( Barrett 2001). Urinary incontinence is defined as the complaint of any involuntary leakage of urine ( Abrams 2002).

OVERFLOW INCONTINENCE STROKE TRIAL

There were no apparent differences other than in the trial of meclofenoxate where fewer participants had urinary symptoms in the active group than in the control group (9/40 vs. Pharmacotherapy and hormonal interventions There were three small trials that included groups allocated meclofenoxate, oxybutinin or oestrogen. 38/54 RR 0.77, 95% CI 0.59 to 0.99) and statistically significantly more being satisfied with care.Ĭomplementary therapy interventions Three small trials all reported fewer participants with incontinence after acupuncture therapy (overall RR 0.44 95% 0.23 to 0.86), but there were particular concerns about study quality. 10/13 RR 0.06, 95% CI 0.01 to 0.43) in the second trial, assessment and management by Continence Nurse Advisors was associated with fewer participants having urinary symptoms (48/89 vs. Results tended to favour the intervention groups: in a small trial in early rehabilitation, fewer people had incontinence at discharge from hospital after structured assessment and management than in a control group (1/21 vs.

OVERFLOW INCONTINENCE STROKE PROFESSIONAL

Specialised professional input interventions Two trials assessed variants of professional input interventions. All had small sample sizes and confidence intervals were wide. Participants were from a mixture of settings, age groups and phases of stroke recovery.īehavioural interventions Three trials assessed behavioural interventions, such as timed voiding and pelvic floor muscle training. Twelve trials with a total of 724 participants were included in the review.

Overflow incontinence stroke