title: Urinary incontinence after ischemic stroke: clinical and urodynamic studies.
abstract: OBJECTIVE
  To investigate the frequency, the prognostic effect on functional status and the urodynamic patterns of post-stroke urinary incontinence (UI) in a sample of in-patients affected by ischemic stroke.
  
  
  METHODS
  One hundred six patients with recent ischemic stroke admitted to a neurorehabilitation unit were enrolled. Stroke localization was made according to the Oxfordshire Community Stroke Project (OCSP) stroke subtypes and assessment of stroke severity using the National Institute of Health Stroke Scale (NIHSS). The presence of UI was associated with functional status, measured with Barthel Index and Functional Independence Measure (FIM). At admission, urodynamic studies were performed on all the patients and repeated in 63 patients after 30 days.
  
  
  RESULTS
  Eighty-four patients (79%) were incontinent. Incontinence was associated with age (P<0.05) and functional disability (P=0.01), but not with sex, side of stroke, or time from stroke to entry in the study. Urodynamic studies, performed on all 106 patients at admission, showed normal studies in 15%, detrusor overactivity (DO) in 56%, detrusor overactivity with impaired contractility (DOIC) in 14%, and detrusor underactivity (DU) in 15%. After 1 month urodynamic studies, repeated on 63 patients, showed normal studies in 30%, DO in 48%, DOIC in 6%, and DU in 16%.
  
  
  CONCLUSIONS
  Incontinent patients showed a worse functional outcome compared to continent patients. Post-stroke incontinence may be associated with different urodynamic patterns, each of which may necessitate different treatment strategies. Urodynamic findings in patients with ischemic stroke vary depending upon timing of the study.
authors.affiliation: Neurorehabilitation Unit, Don C. Gnocchi Foundation, IRCCS, Florence, Italy.
authors.forename: Assunta
authors.initials: A
authors.lastname: Pizzi
authors.forename: Catiuscia
authors.initials: C
authors.lastname: Falsini
authors.forename: Monica
authors.initials: M
authors.lastname: Martini
authors.forename: Mario Alberto
authors.initials: MA
authors.lastname: Rossetti
authors.forename: Sonia
authors.initials: S
authors.lastname: Verdesca
authors.forename: Aldo
authors.initials: A
authors.lastname: Tosto
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000534:rehabilitation; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D011446:Prospective Studies; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D014549:Urinary Incontinence / Q000209:etiology* / Q000503:physiopathology* / Q000534:rehabilitation; D014563:Urodynamics
keywords: functional outcome; ischemic stroke; urinary incontinence; urodynamics