Incontinence as a Symptom of Strokes

What Causes Incontinence in Individuals Who Have Experienced Strokes?

When an individual experiences a stroke, brain damage from the stroke can occur near the micturition center of the brain (where bladder function is located). Because of this damage, bladder function can be impacted, which can result in urinary incontinence or even urinary retention (inability to void the bladder completely). Urinary incontinence can make bladder control difficult for stroke survivors, even if the loss of control is only minimal bladder leakage. Loss of bowel control can also occur in individuals post-stroke. Bowel incontinence can be managed with disposable briefs and bowel training.

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Symptoms of Incontinence After Stroke

There are various signs of incontinence to be aware of that can occur in stroke recovery. 

  • Urinary frequency and / or urinary urgency
  • Nocturia or nighttime urination as well as nocturnal enuresis (wetting the bed at night)
  • Urinary retention or incomplete bladder emptying. This can lead to overflow incontinence, constipation (which can cause incontinence), and even stress incontinence if the stroke has impacted the ability for pelvic floor muscles to contract / engage to support the bladder and urethra if sneezing or coughing occurs.

How Long Can Incontinence Last After a Stroke?

Most stroke victims suffer from urinary incontinence after their incidence. However, only about 15% will have lasting incontinence one year after suffering from the stroke. Most stroke survivors are faced with motor impairments following a stroke which can interfere with the ability to make it to the restroom in time, leading to functional incontinence. Everyone recovers from a stroke at different timeframes, so working towards muscle retraining, including pelvic floor muscles and bladder training can help during the process to voiding well and limiting continence problems.

Can Incontinence After a Stroke Be Cured?

Incontinence after stroke can absolutely be cured, but it will take time and most incontinence symptoms can be improved. Again, remember everyone heals differently from a stroke and the hope is to get the individual back to as close as they were functioning prior to the stroke, and this includes bladder function. For example, if the individual was struggling with urinary urgency prior to the stroke, it could worsen or take longer to improve post-stroke. While recovering from a stroke and dealing with incontinence symptoms, individuals, or their loved ones, can supplement their treatment with continence products such as bladder control pads and protective underwear.

Treating Incontinence Post-Stroke

I highly encourage pelvic floor physical therapy for incontinence after a stroke. Pelvic floor PTs have extra training for pelvic health concerns including bladder, bowel, and pelvic floor muscle functionality. Pelvic floor muscle training can help individuals gain better control of their bladder muscles via the pelvic floor. The type of pelvic floor training will be dependent on the type of incontinence the individual is experiencing. Often, we think about using a physical therapist for mobility function, however adding a pelvic floor PT can increase the process of improvement. Should incontinence continue to be a concern, medications (anticholinergics and/or beta-adrenergics) can be helpful for urinary urgency and frequency.

If urinary retention is the issue, intermittent catheterization can be helpful as well as timed voiding and avoidance of constipation. Increased water consumption is helpful as well and fluid intake should not be limited as this can lead to constipation, urinary tract infection, dehydration, and kidney failure. However, being strategic about volume and frequency of water can help curb how fast the bladder fills. For functional incontinence when mobility is a concern for getting to the restroom in time, the use of protective underwear can be helpful. Bladder botox is also a viable option for urge incontinence. Sacral neuromodulation can be helpful for urge and incomplete bladder emptying. A combination of all the options can help optimize functionality, as well.

If you, or a loved one, is dealing with bladder or bowel problems post-stroke, Aeroflow Urology can help. Aeroflow Urology provides individuals or caregivers with the continence care products they need to manage their incontinence symptoms. Quality of life does not need to be hindered due to incontinence symptoms. Stroke patients can live with confidence knowing they are protected with incontinence supplies at no cost through their insurance. Aeroflow will ship the products in discreet packaging straight to your door each month. To check your eligibility, fill out our quick and easy 2-step form.

Aleece Fosnight

Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, NCMP, IF, HAES is a Medical Advisor and Writer for Aeroflow Urology and a board-certified physician assistant specializing in sexual medicine, women’s health, and urology. In 2019, she opened up her own private practice, the Fosnight Center for Sexual Health, and implemented the sexual health grand rounds curriculum at her local hospital and residency program.

Aleece is also the founder of the Fosnight Foundation, a non-profit organization dedicated to the education and training of professionals in the sexual health field and providing funding for access to healthcare services in her local community.

Information provided on the Aeroflow Urology blog is not intended as a substitute to medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.