Impact of stroke etiology, lesion location and aging on post-stroke urinary incontinence as a predictor of functional recovery

Abstract

This retrospective study aims to assess the relationship of age, gender, lesion location, stroke etiology and recurrence of stroke to post-stroke urinary incontinence, and to evaluate its impact on functional recovery in patient subgroups with different etiologies, lesion locations and ages. One-hundred-and-sixty-three stroke patients participated in the study. Among them, 141 had detailed imaging tests for the definition of lesion locations. Post-stroke urinary incontinence was defined as an inability to respond to questions regarding toilet needs, evidence of elevated post-stroke urinary incontinence and retention. Successful rehabilitation was described as a total functional independence measure score over 80 at discharge. Cerebrovascular lesion locations were categorized as cortical, subcortical and disseminated. The study found that post-stroke urinary incontinence had a significant negative impact on successful stroke rehabilitation. Post-stroke urinary incontinence was a better indicator of negative functional outcome in hemorrhagic versus ischemic stroke patients and patients with cortical versus subcortical lesions. The incidence of post-stroke urinary incontinence in patients aged over 75 years was higher than in patients under 75 years (P=0.031). In conclusion, post-stroke urinary incontinence was a strong negative predictor of poor outcome in all stroke subgroups. It was related to age, but not to any other pre-selected factor investigated in this study.