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Evidence summaries

Treatment of Urinary Incontinence after Stroke

Structured specialist professional assessment and management of care and specialist continence nursing may reduce urinary incontinence after stroke. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 12 studies with a total of 724 subjects from a mixture of settings, age groups and phases of stroke recovery.

Two trials assessed professional input interventions. Early rehabilitation reduced the number of people with incontinence at hospital discharge (1/21 vs 10/13; RR 0.06, 95% CI 0.01 to 0.43) in one trial and assessment and management of care by Continence Nurse Practitioners in a community setting reduced the number of urinary symptoms (48/89 vs 38/54; RR 0.77, 95% CI 0.59 to 0.99), and increase satisfaction with care in another trial. Reported data were insufficient to evaluate acupuncture, timed voiding, pelvic floor muscle training, sensory motor biofeedback, oxybutynin, meclofenoxate, or oestrogen.

Comment: The quality of evidence is downgraded by study quality (limitations in study quality) and by imprecise results (few patients and wide confidence intervals).

    References

    • Thomas LH, Cross S, Barrett J, French B, Leathley M, Sutton CJ, Watkins C. Treatment of urinary incontinence after stroke in adults. Cochrane Database Syst Rev 2008 Jan 23;(1):CD004462. [PubMed]

Primary/Secondary Keywords