PREVALENCE OF URINARY INCONTINENCE IN COMMUNITY-DWELLING WOMEN STROKE SURVIVORS – A CROSS-SECTIONAL STUDY

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John Solomon, Kari Bø, Aparna Pai, Chythra Rao, Sanya Anklesaria, Preetha Ramachandra, Shashikiran Umakanth
Purpose:

Previous studies have reported the prevalence of urinary incontinence among stroke survivors to be ranging from 10-40%. However, the prevalence of urinary incontinence among women stroke survivors remains underreported. Identifying the prevalence and type of urinary incontinence among women stroke survivors will help us to understand the gravity of the existing issue and to develop measures to mitigate them. 

Methods:

Following ethics approval, 172 community dwelling women stroke survivors living in southern west coast region of India were recruited between January 2024 to September 2024. Women were included if they had a diagnosis of stroke, onset of stroke ≥ 1 month with functional comprehension and communication and if they were medically stable. Participants were excluded if they had presence of pelvic floor dysfunctions before stroke, medications that affect bladder function, previous pelvic surgeries that affect bladder function, other neurological disorders, National Institutes of Health (NIH) Stroke Scale Score ≥ 25, diagnosed diabetic cystopathy or any severe comorbidities such as renal failure, dementia, Alzheimer’s disease, etc. After obtaining written informed consent, demographic details of the participants were recorded, and a self-developed and validated Stroke Pelvic Floor and Perineal Hygiene Questionnaire was administered to the participants by the primary investigator via a face-to-face interview.   

Results:

Of the 172 participants, 73 participants (42.5%) reported a new onset urinary incontinence post-stroke. 66 participants (38.7%) reported having symptoms of increased urgency leading to incontinence, 18 participants (10.5%) reported symptoms of stress urinary incontinence, 12 participants (7%) had symptoms of overflow incontinence, and 24 participants (14%) reported leakage of urine without any prior sensation of urination. Of the 73 participants who reported urinary incontinence, 64 participants attributed the cause of their incontinence to be related to poor bladder control and 9 participants mentioned the cause of incontinence to be difficulty in walking to the washroom due to stroke-related impairments. Commonly used protections for urine leakage were underpants and diapers. Despite these difficulties, none of the participants who had symptoms of urinary incontinence had reported it to their clinicians.


Conclusion(s):

Our findings suggest that the prevalence of urinary incontinence among community dwelling women stroke survivors is 42.5%. The commonest type of incontinence identified was urgency urinary incontinence. Future studies should focus on developing management programs for incontinence among women stroke survivors living in the community. 

Implications:

Urinary incontinence must be considered as a common post-stroke complication. Regular assessments and timely management must be conducted to identify and treat urinary incontinence among stroke survivors. 

Funding acknowledgements:
No funding was provided for this work
Keywords:
Prevalence
Stroke
Urinary incontinence
Primary topic:
Women's health
Second topic:
Neurology: stroke
Third topic:
Pelvic, sexual and reproductive health
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The study was approved by the Institutional Ethics Committee, Kasturba Hospital, Manipal on November 30, 2023
Provide the ethics approval number:
IEC1: 348/2023
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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