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

BACKGROUND

there are limited population-based data on urinary symptoms and the natural history of urinary incontinence after a first stroke.

OBJECTIVE

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).

CONCLUSIONS

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.