Urine Problem After Stroke

by sayed
(India)

Question: My father attacked with stroke and currently not in control of urine.He says he doesn't know the urine is coming until it comes.

Answer: Urinary incontinence is very common after stroke especially in the beginning stages. Many patients will regain control over their bladder as they heal from their stroke. Others may continue to have incontinence. Tips to follow include:

•Establish a toileting schedule (i.e. - set a timer for every 2 hours to go to the bathroom which helps train the bowel and bladder)

•Practice Kegel exercises which strengthen the pelvic floor.

•Ask your physician about medications for overactive bladder if the condition persists

•Examine medications with your M.D. to make sure they are not causing urinary or bowel problems

•Tell your father to notify staff or family immediately of the need to urinate or move his bowels as soon as it comes on - waiting can lead to accidents.

•Limit fluids in the evening before bed

•Limit caffeine

•Use disposable undergarments until he can regain control

Bladder and Incontinence Problems

Bladder Sensation
Question:Is it common for stroke survivor to repeatedly say they have to go to the bathroom even after having just urinated?

Answer: Some stroke victims have trouble with getting the bladder to empty completely after a stroke, so they feel that they have to urinate more often. This is often due to decreased control of the detrussor muscle, the primary muscle that controls the bladder. The muscle can become overactive trying to empty the bladder even when it is not full. Urinary tract infections are common after stroke as well and can cause frequent urination. If needed, there are medications to help with both of these conditions so consult a physician if the urge to urinate persists.



Incontinence Problems
by Jerry
(New Brighton, PA)
Question: I had a stroke in 2000. I had incontinence as a result of the stroke, but I regained continence six months later. My question is, can incontinence come back as a result of my disability from the stroke?

Answer: If you regained continence and maintained it for years after a stroke, it is unlikely that any new problems with incontinence would be related to the past stroke.


To learn more about bladder and bowel incontinence after stroke, please visit www.stroke-rehab.com/bowel-and-bladder-incontinence.html

Getting to the toilet

by Shosh
(Calif)

Question: My husband had a stroke and can't use his left arm or leg. He also had a colectomy and has numerous loose stools. He wants to use the toilet, but can not yet safely do so. Diapers are difficult because he needs to not be siting directly on his bum The pressure does not allow for elimination. He's a big guy.
There must be some type of assistive device for someone in this position. Please help. His quality of life would improve drastically if we could figure this out. We can't be the only ones facing this dilemma.

Answer: There are many devices out there to help with transfers and/or toileting. In order to know which one would work for your husband, you need to have a home visit done by an occupational therapist to evaluate his need. Let them know the specific goal of being able to allow your husband to do a toilet transfer or find a way to toilet easily. Not all therapists are aware of the different devices out there, so the therapist may need to do a little research to find the right device for your husband. Many lifts are expensive, so you would have to see if anything would be covered by insurance or not. Many stroke patients (even when large) can learn to transfer to the toilet even with paralysis of one side, so the therapist may just need to work on transfer techniques with you. They even have transfer boards that have holes in them to go over the toilet. Also, there are adaptive clothes that are more easily removed, so that may be something he needs as well.

Here is a link with info on adaptive clothing: www.buckandbuck.com

Here are some Google images of various toilet transfer assistive devices (make sure to scroll down as the top ones are mostly ads and not as relevant to your situation):

toilet transfer assistive aides

ileostomy and hemiparesis

Question I have Left side paralysis and just got ileostomy. Are there any products available to change appliances independently with one hand?

Answer: The Ileostomy and Internal Pouch Support Group has a leaflet out on how to change an ileostomy with one hand. It can be found at http://iasupport.org/pdfs/OneHandedLeaflet.pdf.