Lower Urinary Tract Dysfunction (LUTD) is a condition that is common in stroke patients and affects their quality of life and psychological state.
Aim
To determine the factors affecting LUTD severity in stroke patients and to evaluate its relationship with functional status.
Method
77 stroke patients were included in our study. Demographic and stroke characteristics of all patients were recorded. Functional Ambulation Scale (FAS), Functional Independence Measure (FIM), the Core Lower Urinary Tract Symptom Score (CLSS) Questionnaire, Beck Depression Scale were administered to the patient. 33 of 77 patients had urodynamic study and these patients constituted the subgroup of the study. Patients were grouped according to type of disorder, type of detrusor and detrusor sphincter dyssynergia (DSD) using urodynamic study findings.
Result
The mean CLSS of men was significantly higher than women (P = 0.017). A significant positive correlation was found between age and CLSS (P = 0.035 r = 0.24) and negative correlation was found between total FIM and all sub-parameter scores and mean of CLSS (P = 0.001 r = -0.467).
Conclusion
LUTD is common in stroke patients and the presence of urinary symptoms is associated with poor functional status. No significant relationship was observed between urodynamic data except maximum flow rate and CLSS.
Stroke-1989. Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO task force on stroke and other cerebrovascular disorders. Stroke1989; 20: 1407–1431.
2.
WeinA. Commentary RE: the standardization of terminology in lower urinary tract function: report From the standardization subcommittee of the international continence society. Urology2020; 20: 450–457.
3.
BrittainKRPerrySIPeetSM,et al.Prevalence and impact of urinary symptoms among community-dwelling stroke survivors. Stroke2000; 31: 886–891.
4.
WilliamsMPSrikanthVBirdM,et al.Urinary symptoms and natural history of urinary continence after first-ever stroke--a longitudinal population-based study. Age Ageing2012; 41: 371–376.
5.
ThomasLHCoupeJCrossLD,et al.Interventions for treating urinary incontinence after stroke in adults. Cochrane Database Syst Rev2019; 2: CD004462.
6.
AkkoçYBardakANErsözM, et al.Post-stroke lower urinary system dysfunction and its relation with functional and mental status: a multicenter cross-sectional study. Top Stroke Rehabil2019; 26: 136–141.
7.
TibaekSGardGKlarskovP,et al.Prevalence of lower urinary tract symptoms (LUTS) in stroke patients: a cross-sectional, clinical survey. Neurourol Urodyn2008; 27: 763–771.
ErsozMErhanBAkkocY, et al.An evaluation of bladder emptying methods and the effect of demographic and clinical factors on spontaneous voiding frequency in stroke patients. Neurol Sci2013; 34: 729–734.
10.
EdwardsDFHahnMDromerickA. Post stroke urinary loss, incontinence and life satisfaction: when does post-stroke urinary loss become incontinence. Neurourol Urodyn2006; 25: 39–45.
11.
MiyazatoMTanaTHigaA, et al.A questionnaire survey to assess lower urinary tract symptoms in patients with chronic stroke. Neurourol Urodyn2017; 36: 1890–1895.
12.
AkkoçYYıldızNBardakAN, et al.The course of post-stroke bladder problems and their relation with functional and mental status and quality of life: a six-month, prospective, multicenter study. Turk J Phys Med Rehabil2019; 65: 335–342.
13.
DombovyMLBach-y-RitaP. Clinical observations on recovery from stroke. Adv Neurol1988; 47: 265–276.
14.
MeijerRIhnenfeldtDSde GrootIJ,et al.Prognostic factors for ambulation and activities of daily living in the subacute phase after stroke. A systematic review of the literature. Clin Rehabil2003; 17: 119–129.
15.
HommaYYoshidaMYamanishiT,et al.Core lower urinary tract symptom score (CLSS) questionnaire: a reliable tool in the overall assessment of lower urinary tract symptoms. Int J Urol2008; 15: 816–820.
16.
BarryMJFowler JrFJO'LearyMP,et al.The American urological association symptom index for benign prostatic hyperplasia. The measurement committee of the American urological association. J Urol1992; 148: 1549–1557.
17.
HoldenMKGillKMMagliozziMRGait assessment for neurologically impaired patients. Standards for outcome assessment. Phys Ther1986; 66: 1530–1539.
18.
KüçükdeveciAAYavuzerGElhanAH,et al.Adaptation of the functional independence measure for usein Turkey. Clin Rehabil2001; 15: 311–319.
19.
HisliN. Back depresyon envanteri geçerliliği üzerine bir çalışma. Turkish J Psychol1987; 6: 118–122.
20.
Kolominsky-RabasPLHilzMJNeundoerferB,et al.Impact of urinary incontinence after stroke: results from a prospective population-based stroke register. Neurourol Urodyn2003; 22: 322–327.
21.
PizziAFalsiniCMartiniM,et al.Urinary incontinence after ischemic stroke: clinical and urodynamic studies. Neurourol Urodyn2014; 33: 420–425.
22.
GelberDAGoodDCLavenLJ,et al.Causes of urinary incontinence after acute hemispheric stroke. Stroke1993; 24: 378–382.
23.
TurhanNAtalayAAtabekHK. Impact of stroke etiology, lesion location and aging on post-stroke urinary incontinence as a predictor of functional recovery. Int J Rehabil Res2006; 29: 335–338.
24.
SonSBChungSYKangS,et al.Relation of urinary retention and functional recovery in stroke patients during rehabilitation program. Ann Rehabil Med2017; 41: 204–210.
25.
FederMHellerLTadmorR,et al.Urinary continence after stroke: association with cystometric profile and computerised tomography findings. Eur Neurol1987; 27: 101–105.
LinsenmeyerTAZorowitzRD. Urodynamic findings in patients with urinary incontinence after cerebrovasculer accidebt. Neurol Rehabil1992; 2: 23–26.
28.
GuptaATalyABSrivastavaA,et al.Urodynamics post stroke in patients with urinary incontinence: is there correlation between bladder type and site of lesion. Ann Indian Acad Neurol2009; 12: 104–107.
29.
KimTGYooKHJeonSH,et al.Effect of dominant hemispheric stroke on detrusor function in patients with lower urinary tract symptoms. Int J Urol2010; 17: 656–660.
30.
ErsozMTuncHAkyuzM,et al.Bladder storage and emptying disorder frequencies in hemorrhagic and ischemic stroke patients with bladder dysfunction. Cerebrovasc Dis2005; 20: 395–399.
31.
KongKHYoungS. Incidence and outcome of poststroke urinary retention: a prospective study. Arch Phys Med Rehabil2000; 81: 1464–1467.
32.
GarrettVEScottJACostichJ,et al.Bladder emptying assessment in stroke patients. Arch Phys Med Rehabil1989; 70: 41–43.
33.
ChouYCJiangYHHarnodT,et al.Characteristics of neurogenic voiding dysfunction in cerebellar stroke: a cross-sectional, retrospective video urodynamic study. Cerebellum2013; 12: 601–606.
34.
HanKSHeoSHLeeSJ,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 Urodyn2010; 29: 387–390.
