Urinary symptoms and natural history of urinary continence after first-ever stroke—a longitudinal population-based study

Abstract

Background: there are limited population-based data on urinary symptoms and the natural history of urinary incontinence after a first stroke. Aim: to study the prevalence of urinary symptoms, and the natural history and factors associated with urinary incontinence after first-ever stroke. Methods: we administered a standardised urinary symptom questionnaire at 3 and 12 months after stroke to patients enrolled in the North-East Melbourne Stroke Incidence Study. Urinary symptoms and evolution of urinary incontinence were recorded. Logistic regression was used to model associations between baseline factors and incontinence at 12 months. Results: more than 80% of survivors reported one or more abnormal urinary symptoms at 3 or 12 months, with nocturia most frequent. Incontinence was present in 43.5% of patients at 3 months, and 37.7% at 12 months, with urge incontinence being most common. Pre-stroke continence (P < 0.001) and female sex (P < 0.001) were independently associated with incontinence at 12 months, whereas the effect of greater stroke severity was magnified with advancing age (P for interaction = 0.05). Conclusion: the majority of survivors reported abnormal urinary symptoms early and late after stroke. Around a third of patients had incontinence at 12 months, with pre-stroke UI, age, female sex and stroke severity predicting its presence.