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(Stroke. 1998;29:524-528.)
© 1998 American Heart Association, Inc.

Comments, Opinions, and Reviews

Stroke and Incontinence

K. R. Brittain, MA; S. M. Peet, PhD; C. M. Castleden, MD, FRCP

From the Division of Medicine for the Elderly, Leicester University, Leicester General Hospital (UK).

Correspondence to K.R. Brittain, Division of Medicine for the Elderly, Leicester University, Leicester General Hospital, Gwendolen Rd, Leicester LE5 4PW, UK. E-mail krb7{at}leicester.ac.uk

Background—Urinary incontinence in the acute stage of stroke is seen as a predictor of death, severe disability, and an important factor on hospital discharge destination. Therefore, it is an important measure of stroke severity that not only affects the lives of stroke survivors but also those of caregivers.

Summary of Review—A number of studies have linked the presence of bladder dysfunction in stroke survivors to various neurological lesions in areas thought to be primarily involved in micturition. However, neurological deficits may affect management of bladder control secondarily by apraxia or aphasia, for example, and a significant number of strokes occur in individuals already experiencing incontinence.

Conclusions—Despite incontinence being such an important prognostic feature, there are many gaps in our knowledge of the relationship of stroke and incontinence, particularly fecal incontinence. There are almost no studies on the influence of achieving continence on outcome or how this might be brought about. This article reviews the literature on this important topic and highlights deficiencies in our knowledge and areas of future research.

Key Words: urinary incontinence • fecal incontinence • stroke outcome • neurology

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