How Long Does Incontinence Last After a Stroke?
Following a stroke, you may develop incontinence. This occurs because the muscles that control the bladder and the bowels become weak. The most common incontinence symptom is unconscious leaking, but you may experience other types of bowel and bladder incontinence.
It can be reassuring to know incontinence after a stroke is very common. Though distressing when they first occur, symptoms usually resolve over time and with the right treatment. If you or a loved one has incontinence after a stroke, whether bowel incontinence, urinary incontinence, or both, it's important to know what to expect and how long the symptoms may last. Learn more about incontinence after a stroke, the risk factors involved, and the treatment options available.
Incidence of Incontinence After Stroke
If you are experiencing incontinence after a stroke, you are not alone and help is available. Urinary incontinence can affect up to 60% of stroke patients, with 25% still experiencing symptoms after hospital discharge, and up to 15% remaining incontinent months after discharge.
The type of incontinence you experience may differ depending on the severity of your stroke and your recovery. For example, you may suffer from urge incontinence, where there is an urgent need to pass urine. Another type of incontinence common in stroke patients is stress incontinence where urine leaks when laughing or sneezing.
Risk factors that can impact the incidence of incontinence after stroke include:
- Age
- Sex
- Smoking
- Hypertension
- Diabetes
- Heart disease
- History of former stroke
Many stroke survivors are comforted learning long-term incontinence following a stroke is rare and their condition is temporary. Nevertheless, temporary incontinence can still be upsetting. The condition's prevalence is often linked to the risk factors above, the treatment provided, and any lasting damage caused by the stroke itself.
Duration of Incontinence After Stroke
Most stroke victims have some level of urinary incontinence. Motor impairments may prevent you from reaching the restroom in time, or you may leak urine when you least expect it or without knowing. Everyone recovers from a stroke in a different time frame. Some may experience short-term incontinence for a week or so, while others may experience incontinence for several months or longer.
Short-term incontinence after a stroke can often improve on its own as the brain heals. Treatments include bladder control exercises and medication. Incontinence products, such as protective underwear or bladder control pads, can also supplement any treatments you are receiving.
If you still experience urinary or bowel incontinence months after your stroke, many treatments can be tailored to suit your specific needs. Long-term incontinence is rare and often related to other risk factors or areas the stroke has greatly affected mobility, communication, or cognitive ability.
You may have urinary incontinence because your bladder or surrounding muscles have weakened as a result of your stroke. As the brain heals, so do nerves around the body. It's common for the bladder to make a full recovery. If problems continue, bladder training may be required.
Factors Affecting Duration of Incontinence After Stroke
The long-term effects of a stroke largely depend on which area of the brain has been affected and the severity of the damage. Other factors can affect the duration of incontinence after stroke and impact recovery.
While incontinence is a common symptom of stroke, it rarely leads to long-term complications or symptoms. However, the age and overall health of the stroke survivor play an important part in recovery. For example, a 75-year-old stroke survivor who smokes and has diabetes may experience a significantly slower incontinence recovery than a 60-year-old stroke survivor with no other risk factors. The 75-year-old may also go on to experience long-term incontinence problems.
The type of incontinence can also dictate the duration of incontinence after a stroke. Stroke survivors most commonly experience reflex incontinence. This occurs when the part of the brain that senses and controls bladder movement has become damaged. However, this type of incontinence can be treated. Treatment options may involve medication, behavioral training, medical devices, and sometimes surgery. Other types of incontinence, such as stress incontinence, urge incontinence, or functional incontinence, can also be improved with the right treatment.
Treatment Options and Their Impact on Duration of Incontinence
Fortunately, stroke survivors have many treatment options that can vastly reduce the severity and duration of incontinence. Treatments for post-stroke incontinence may include:
- Behavioral interventions: Bladder training can help reduce the frequency and urgency of urination by training the bladder to hold urine.
- Medication: Medication can reduce the feelings of urgency and reduce the volume of urine your body produces.
- Nerve stimulation: Electrical stimulation devices can strengthen the muscles controlling the bladder.
- Surgery: In rare cases, a surgical procedure can prevent involuntary leaks from stress incontinence.
- Catheterization: A catheter may be recommended for the short-term or long-term depending on the severity of your incontinence.
Prognosis and Recovery
Compromised bladder control is a common cause of incontinence after a stroke. By following a bladder retraining plan early in your recovery, you can significantly improve your chances of making a full recovery. For example, your caregiver may give you a series of pelvic floor muscle exercises to restore your bladder's strength and control.
Other treatments with a good success rate include medications that help slow down the amount of urine the body produces or reduce the urge to urinate. It can take several weeks before symptoms begin to improve. Nerve stimulation devices, used alongside bladder control exercises, can also build strength in a bladder weakened by nerve damage.
The impact of incontinence on your quality of life and psychological well-being can be great. If it's not managed well, you may start to experience feelings of isolation, rejection, and a loss of independence. You may lose confidence in your body image over time. It's important to get the right physical treatment as quickly as possible, so you can see there's light at the end of the tunnel.
Coping Strategies
With the right treatment and management of risk factors where possible, many stroke survivors can live normal lives without incontinence. One of the most common coping tactics is to limit leakage by restricting fluids within safe levels, visiting the toilet regularly, and practicing behavioral exercises. Making the right food choices and stopping smoking can also be highly effective. Improving your lifestyle not only reduces the risk of long-term incontinence but can also reduce the risk of another stroke.
A good support network, whether through friends and family or a professional caregiver, is also important for your mental well-being and progress. Incontinence doesn't need to be all-encompassing or life-changing. With the right support and help, incontinence can be manageable and treatable.