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  • Overactive Bladder and Lower Urinary Tract Symptoms (U Lee and S Adelstein, Section Editors)
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Managing of Lower Urinary Tract Dysfunction Following Stroke

Abstract

Purpose of Review

This comprehensive up-to-date review will synthesise relevant available literature on the topic of post-stroke lower urinary tract dysfunction (LUTD). Topics include epidemiology of LUTD, LUTD as a prognostic indicator for stroke recovery, urinary incontinence and retention, correlations between brain lesion localisation and LUTD, causes of LUTD, medical complications due to LUTD, diagnostics and contemporary management of LUTD in stroke patients.

Recent Findings

LUTD frequently occurs after a stroke and is associated with poor overall functional outcome, increased institutionalisation and mortality rates. The predominant symptoms are urinary frequency, urgency and urge incontinence. In the urodynamic findings, detrusor overactivity is predominant and detrusor underactivity is somewhat less prevalent. LUTD is correlated with the size and site of the brain lesion, and the presence of cognitive, motor, sensory, vision impairment and aphasia. There are multiple aetiologies for LUTD and the treatment usually includes continence aids, behavioural, pharmacological and surgical measures. A variety of behavioural therapeutic interventions is described in the literature, including bladder training and pelvic floor muscle training, but the evidence of the effectiveness is still sparse.

Summary

LUTD after a stroke remains under-recognised, poorly addressed and there is still a lack of clinical practice guidelines available in the literature. At the moment, a structured clinical assessment and the use of a multimodal treatment approach that includes a systematic voiding programme with the participation of all team members is recommended. In the future, additional evidence-based research should be performed to evaluate the effectiveness of various therapeutic approaches.

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Correspondence to Nataša Bizovičar.

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Nataša Bizovičar declares that she has no conflict of interest.

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This article is part of the Topical Collection on Overactive Bladder and Lower Urinary Tract Symptoms

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Bizovičar, N. Managing of Lower Urinary Tract Dysfunction Following Stroke. Curr Bladder Dysfunct Rep 13, 125–131 (2018). https://doi.org/10.1007/s11884-018-0472-5

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Keywords

  • Stroke
  • Lower urinary tract dysfunction
  • Urinary retention
  • Urinary incontinence
  • Urodynamics
  • Systematic voiding programme