Urinary Incontinence Post Stroke

Understanding the Neurogenic Bladder

A stroke can dramatically impact an individual in many ways. 15% of stroke survivors after a year have incontinence, statistically supported by the Stroke Association. Urinary incontinence is a major quality of life issue, affecting the ability to control the flow of urine without experiencing leakage while participating in social activities.  

After initial stroke recovery, one may experience a neurogenic bladder.  A neurogenic bladder is described as the loss of voluntary urinary control due to a central or peripheral nervous system disorder; resulting in an over-active or under-active bladder.

 
 The normal bladder capacity before you feel any sensation of urge is about 300cc's (the middle jar). Normal FULL capacity of the bladder ranges anywhere from 400-600 ( 3rd jar). It's important to understand normal before understanding abnormal! The symptom of urinary frequency is usually defined as voiding 8 or more times per day. On the flip side, urinary retention is defined as the inability to empty the bladder and becomes problematic when the post void residual amount of urine measures more than 100cc's. By the way, BOTH of these presentations of urinary dysfunction can be successfully treated with pelvic floor PT!

The normal bladder capacity before you feel any sensation of urge is about 300cc's (the middle jar). Normal FULL capacity of the bladder ranges anywhere from 400-600 ( 3rd jar). It's important to understand normal before understanding abnormal! The symptom of urinary frequency is usually defined as voiding 8 or more times per day. On the flip side, urinary retention is defined as the inability to empty the bladder and becomes problematic when the post void residual amount of urine measures more than 100cc's. By the way, BOTH of these presentations of urinary dysfunction can be successfully treated with pelvic floor PT!

Neurogenic Bladder symptoms

  • Urinary Incontinence with the feelings of constant wetness or incomplete emptying

  • Urgency without the ability to void urine

  • Slow stream or flow of urine

  • Requiring manual compression above bladder to void

  • Increased pressure above pelvis or discomfort without the ability to void urine

  • Recurrent UTIs

  • Nocturia

  • Painful urination

Understanding the neuromuscular implications after a stroke can heavily influence the symptoms through pelvic floor rehabilitation.  Addressing the motor and sensory components through skilled interventions and treatments can lead to improved life satisfaction, decrease episodes of leaking, and decrease use of self-cathertization.

Neurogenic bladder treatment approaches would consist of:

  • Facilitation or Inhibition techniques that assist with bladder control

  • Positional training

  • Myofascial release and connective tissue treatments

  • Identifying voiding patterns by keeping a “bladder diary”

Receiving pelvic floor physical therapy after a stroke can assist in minimizing incontinent symptoms, and re-establishing one’s self into the community without fear of leaking or bladder discomfort.  Let our expert Doctors of Physical Therapy at Sarton support your rehabilitation journey back into wellness

Please contact Sarton Physical Therapy with any questions or to have your patients schedule an appointment.

 
15% of stroke survivors after a year have incontinence.
— The Stroke Association