K H Kong1, S Young. 1. Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore.
Abstract
OBJECTIVE: To document the incidence and outcome of poststroke urinary retention, and to determine clinical variables associated with it. DESIGN: Cohort of 80 consecutive patients. SETTING: Inpatient setting of a tertiary rehabilitation center. PARTICIPANTS: Eighty patients (48 men, 32 women; mean age, 65.4 yr) with a first ischemic stroke, admitted for rehabilitation within 4 weeks of the stroke. MAIN OUTCOME MEASURES: Patients had their postvoid residuals (PVR) assessed via a bladder scanner within 72 hours of admission. Urinary retention was defined by a PVR of more than 100mL on 2 consecutive occasions. RESULTS: Urinary retention was present in 23 (29%) patients. Cognitive impairment, aphasia, diabetes mellitus, and cortical stroke were present in 30%, 29%, 31%, and 41% of patients, respectively. Fifteen (19%) patients developed urinary tract infection during rehabilitation. Urinary retention was significantly associated (p < .05) with cognitive impairment, diabetes mellitus, aphasia, a lower admission functional status (as measured on the modified Barthel index), and urinary tract infection, but not with the use of anticholinergic medications. On discharge, 4 patients still had urinary retention (3 were voiding spontaneously and the other used intermittent catheterization). CONCLUSION: Urinary retention was common in patients with ischemic stroke. It should be strongly suspected in patients with aphasia, cognitive impairment, poor functional status, and diabetes mellitus.
OBJECTIVE: To document the incidence and outcome of poststroke urinary retention, and to determine clinical variables associated with it. DESIGN: Cohort of 80 consecutive patients. SETTING: Inpatient setting of a tertiary rehabilitation center. PARTICIPANTS: Eighty patients (48 men, 32 women; mean age, 65.4 yr) with a first ischemic stroke, admitted for rehabilitation within 4 weeks of the stroke. MAIN OUTCOME MEASURES: Patients had their postvoid residuals (PVR) assessed via a bladder scanner within 72 hours of admission. Urinary retention was defined by a PVR of more than 100mL on 2 consecutive occasions. RESULTS: Urinary retention was present in 23 (29%) patients. Cognitive impairment, aphasia, diabetes mellitus, and cortical stroke were present in 30%, 29%, 31%, and 41% of patients, respectively. Fifteen (19%) patients developed urinary tract infection during rehabilitation. Urinary retention was significantly associated (p < .05) with cognitive impairment, diabetes mellitus, aphasia, a lower admission functional status (as measured on the modified Barthel index), and urinary tract infection, but not with the use of anticholinergic medications. On discharge, 4 patients still had urinary retention (3 were voiding spontaneously and the other used intermittent catheterization). CONCLUSION: Urinary retention was common in patients with ischemic stroke. It should be strongly suspected in patients with aphasia, cognitive impairment, poor functional status, and diabetes mellitus.