More research on stroke patients’ bladder control needed

Approximately 40 out of 100 individuals who admit to a hospital with signs and symptoms of a stroke lose their bladder control. At least 25 of them leave the hospital with the problem after a month. Furthermore, 15 are likely to sustain the problem after a year.

So, urinary incontinence – losing bladder control – is a common problem among stroke survivors.

What can we do about that?

In spite of its high incidence, the attention of the researchers to promote continence among stroke survivors seems to be insufficient.

After searching all research databases in the world, the Cochrane reviewers recently were able to find only 20 research projects aimed at improving bladder control involving just 1338 stroke survivors.

The researchers who conducted these trials have tested a range of interventions; these include behavioral strategies, complementary treatments, the involvement of a specially trained nurse practitioner, and physical treatments such as nerve stimulation.

Behavioral strategies

The reviewers found two trials: one involving 18 stroke survivors and the other with 55 participants. In these studies, they found a reduction of the mean number of incontinence episodes and no effect on the quality of life; however, the study findings were statistically non-significant. More importantly, they further concluded that the studies were of low quality.

Involvement of a continence nurse practitioner

Strangely, the Cochrane reviewers have found only one intervention trial with the involvement of continence nurse practitioners. In this trial of moderate-quality, involving 121 stroke survivors, the reviewers concluded that nurse practitioners made “probably little or no difference” three months after the intervention.

Acupuncture and electro-acupuncture

The reviewers have found five trials of low-quality, involving 524 stroke survivors; these trials have shown that the participants in the treatment arm were three times more likely to be continent. However, they rated that these studies were of low-quality.

Electrical nerve stimulation

The reviewers have found two trials involving 223 stroke survivors. One study has found that it reduced the mean number of incontinent episodes; however, this study was found to be of low quality.

You can read the abstract through this link: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004462.pub4/full

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Author: Prasantha De Silva

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