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Cerebrovascular Accidents

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Handbook of Neurourology

Abstract

Post-stroke urinary incontinence (PSI) is a relatively common occurrence after a stroke or cerebrovascular accident. The most common pattern of micturition disturbance immediately following a stroke is urinary retention proceeded by resolution or the development of urge urinary incontinence (Lee et al., Neurourol Urodyn 36:136–141, 2017). The majority of patients with PSI demonstrate urodynamic evidence of detrusor overactivity (DO) (Pettersen and Wyller, J Am Geriatr Soc 54:1878–1884, 2006). The diagnosis of the underlying cause of the urinary incontinence may guide clinicians to apply the most efficient management strategies, particularly when conservative therapies have failed (Abrams et al., Neurourol Urodyn 29:213–240, 2010). Compared to patients who are continent after a stroke, the development of urinary incontinence following a stroke is associated with an overall poorer prognosis with increased morbidity and mortality (Patel et al., Stroke 32:122–127, 2001).

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References

  1. E.J. Benjamin, P. Muntner, A. Alonso, et al., Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation 139, e56 (2019)

    Article  PubMed  Google Scholar 

  2. A. Pizzi, C. Falsini, M. Martini, et al., Urinary incontinence after ischemic stroke: clinical and urodynamic studies. Neurourol. Urodyn. 33, 420 (2014)

    Article  PubMed  Google Scholar 

  3. M.J. Borrie, A.J. Campbell, T.H. Caradoc-Davies, et al., Urinary incontinence after stroke: a prospective study. Age Ageing 15, 177 (1986)

    Article  CAS  PubMed  Google Scholar 

  4. N.E. Tuong, A.P. Klausner, L.J. Hampton, A review of post-stroke urinary incontinence. Can. J. Urol. 23, 8265 (2016)

    PubMed  Google Scholar 

  5. L. Jacob, K. Kostev, Urinary and fecal incontinence in stroke survivors followed in general practice: a retrospective cohort study. Ann. Phys. Rehabil. Med. 63, 488 (2020)

    Article  PubMed  Google Scholar 

  6. M. Patel, C. Coshall, A.G. Rudd, et al., Natural history and effects on 2-year outcomes of urinary incontinence after stroke. Stroke 32, 122 (2001)

    Article  CAS  PubMed  Google Scholar 

  7. H.S. Lee, J.G. Choi, J.H. Shin, Urological disturbance and its neuroanatomical correlate in patients with chronic brainstem stroke. Neurourol. Urodyn. 36, 136 (2017)

    Article  PubMed  Google Scholar 

  8. T.L. Burney, M. Senapati, S. Desai, et al., Acute cerebrovascular accident and lower urinary tract dysfunction: a prospective correlation of the site of brain injury with urodynamic findings. J. Urol. 156, 1748 (1996)

    Article  CAS  PubMed  Google Scholar 

  9. K.H. Kong, S. Young, Incidence and outcome of poststroke urinary retention: a prospective study. Arch. Phys. Med. Rehabil. 81, 1464 (2000)

    Article  CAS  PubMed  Google Scholar 

  10. S. Tsuchida, H. Noto, O. Yamaguchi, et al., Urodynamic studies on hemiplegic patients after cerebrovascular accident. Urology 21, 315 (1983)

    Article  CAS  PubMed  Google Scholar 

  11. R. Pettersen, T.B. Wyller, Prognostic significance of micturition disturbances after acute stroke. J. Am. Geriatr. Soc. 54, 1878 (2006)

    Article  PubMed  Google Scholar 

  12. N.M. Resnick, S.V. Yalla, Detrusor hyperactivity with impaired contractile function. An unrecognized but common cause of incontinence in elderly patients. JAMA 257, 3076 (1987)

    Article  CAS  PubMed  Google Scholar 

  13. D.A. Gelber, D.C. Good, L.J. Laven, et al., Causes of urinary incontinence after acute hemispheric stroke. Stroke 24, 378 (1993)

    Article  CAS  PubMed  Google Scholar 

  14. V.W. Nitti, H. Adler, A.J. Combs, The role of urodynamics in the evaluation of voiding dysfunction in men after cerebrovascular accident. J. Urol. 155, 263 (1996)

    Article  CAS  PubMed  Google Scholar 

  15. S.P. Marinkovic, G. Badlani, Voiding and sexual dysfunction after cerebrovascular accidents. J. Urol. 165, 359 (2001)

    Article  CAS  PubMed  Google Scholar 

  16. D.A. Ginsberg, T.B. Boone, A.P. Cameron, et al., The AUA/SUFU guideline on adult neurogenic lower urinary tract dysfunction: diagnosis and evaluation. J. Urol. 206, 1097 (2021)

    Article  PubMed  Google Scholar 

  17. D.A. Ginsberg, T.B. Boone, A.P. Cameron, et al., The AUA/SUFU guideline on adult neurogenic lower urinary tract dysfunction: treatment and follow-up. J. Urol. 206, 1106 (2021)

    Article  PubMed  Google Scholar 

  18. Z. Khan, P. Starer, W.C. Yang, et al., Analysis of voiding disorders in patients with cerebrovascular accidents. Urology 35, 265 (1990)

    Article  CAS  PubMed  Google Scholar 

  19. T.A. Linsenmeyer, Post-CVA voiding dysfunctions: clinical insights and literature review. NeuroRehabilitation 30, 1 (2012)

    Article  PubMed  Google Scholar 

  20. K.S. Han, S.H. Heo, S.J. Lee, et al., Comparison of urodynamics between ischemic and hemorrhagic stroke patients; can we suggest the category of urinary dysfunction in patients with cerebrovascular accident according to type of stroke? Neurourol. Urodyn. 29, 387 (2010)

    PubMed  Google Scholar 

  21. A. Wagg, W. Gibson, J. Ostaszkiewicz, et al., Urinary incontinence in frail elderly persons: report from the 5th international consultation on incontinence. Neurourol. Urodyn. 34, 398 (2015)

    Article  PubMed  Google Scholar 

  22. J.C. Van Swieten, P.J. Koudstaa, M.C. Visser, et al., Interobserver agreement for the assessment of handicap in stroke patients. Stroke 19, 604 (1988)

    Article  PubMed  Google Scholar 

  23. R.F. Bloch, Interobserver agreement for the assessment of handicap in stroke patients. Stroke 19, 1448 (1988)

    Article  CAS  PubMed  Google Scholar 

  24. J.C. Winters, R.R. Dmochowski, H.B. Goldman, et al., Urodynamic studies in adults: AUA/SUFU guideline. J. Urol. 188, 2464 (2012)

    Article  PubMed  Google Scholar 

  25. L.H. Thomas, J. Coupe, L.D. Cross, et al., Interventions for treating urinary incontinence after stroke in adults. Cochrane Database Syst. Rev. 2, Cd004462 (2019)

    PubMed  Google Scholar 

  26. P. Abrams, K.E. Andersson, L. Birder, et al., Fourth international consultation on incontinence recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol. Urodyn. 29, 213 (2010)

    Article  CAS  PubMed  Google Scholar 

  27. E. Samuelsson, J. Odeberg, K. Stenzelius, et al., Effect of pharmacological treatment for urinary incontinence in the elderly and frail elderly: a systematic review. Geriatr Gerontol Int 15, 521 (2015)

    Article  PubMed  Google Scholar 

  28. S.F. Chen, H.C. Kuo, Therapeutic efficacy of low-dose (25 mg) mirabegron therapy for patients with mild to moderate overactive bladder symptoms due to central nervous system diseases. Low Urin. Tract Symptoms 11, O53 (2019)

    CAS  PubMed  Google Scholar 

  29. G.Y. Guo, Y.G. Kang, Effectiveness of neuromuscular electrical stimulation therapy in patients with urinary incontinence after stroke: a randomized sham controlled trial. Medicine (Baltimore) 97, e13702 (2018)

    Article  PubMed  Google Scholar 

  30. Z. Panfili, M. Metcalf, T.L. Griebling, Contemporary evaluation and treatment of poststroke lower urinary tract dysfunction. Urol. Clin. North Am. 44, 403 (2017)

    Article  PubMed  Google Scholar 

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Correspondence to Roger R. Dmochowski .

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Gleicher, S., Sebesta, E.M., Dmochowski, R.R. (2023). Cerebrovascular Accidents. In: Liao, L., Madersbacher, H. (eds) Handbook of Neurourology. Springer, Singapore. https://doi.org/10.1007/978-981-99-1659-7_59

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  • DOI: https://doi.org/10.1007/978-981-99-1659-7_59

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-1658-0

  • Online ISBN: 978-981-99-1659-7

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