Central Cause

Due to damage in parts of the brain from stroke.

Drugs

Some medications may affect bladder or bowel control.

Complications

You may be at risk of urinary tract infections which can cause urinary incontinence.

Physical Changes

Physical weakness and loss of sensation may affect your ability to move around. You may not be able to go toilet on time or may have difficulty maintaining control.

Cognitive changes and speech difficulty after stroke may affect your ability to communicate your toilet needs to your carer. 

You may eat or drink less with changes in your diet consistency due to swallowing problems after stroke. Constipation can happen as a result of dehydration and lack of nutrition.

Reduced Physical Activities

Your physical activities may be temporarily reduced due to disabilities after stroke. You may be at risk of experiencing constipation.

Intake and Output Chart

The nurses will monitor the amount you drink, eat, void and the number of bowel movement for several days.

Post-void residual urine measurement

The doctor or nurse may check the amount of leftover urine in your bladder using a bladder scanner or urinary catheter (tube).

A large amount of leftover urine may indicate a urinary tract obstruction or bladder muscles problem.

Urinalysis

If a urinary tract infection is suspected, a sample of your urine may be sent for testing.

If you require maximum physical assistance or are not well enough to regain control of your bladder and bowel, you may be offered to wear diapers.

If you are not able to empty your bladder completely, a urinary catheter may be inserted to drain the urine out into a bag. This may be inserted and kept for a short period of time or to be done several times a day to keep you comfortable and reduce the risk of urinary tract infection.

Bladder training by holding off your urine for an amount of time after having the urge to urinate. This is to strengthen the bladder’s ability to hold more urine and lengthen the time between toilet visits.

Schedule toilet visits every 2 to 3 hours instead of visiting when needed.

Pelvic floor exercises help to strengthen the pelvic floor muscles. This can improve bladder control and reduce urine leakage. 

How to do it?

• Tighten the muscles used for stopping urination and hold for 5 seconds. Then relax for 5 seconds.
• Perform this exercise at least 3 sets of 10 repetitions each day.

• Schedule regular toilet visits to avoid urinary accidents.
• Wear clothes that are easy to unfasten for toileting needs.
• Keep an active lifestyle to promote regular bowel movement.

• Maintain good hygiene and skin care is important to prevent any skin damage.
• Barrier creams can be obtained from the pharmacy to reduce the risk of developing skin rashes and damage.

• Reducing the amount of water intake before bedtime will help avoid late night
  urinary accidents.
• Drink more water during the daytime instead.
• You are encouraged to have 6 to 8 glasses of water per day (unless medically contraindicated). This can help to avoid urinary tract infections and constipation.
• Reduce drinks that contain caffeine (e.g., coffee, tea, coca cola) and alcohol as it may irritate your bladder.
• Consume a healthy, balanced diet. High fibre food can help to prevent constipation.