Background: Incontinence and indwelling catheter (IDC) usage are common after acute stroke. Understanding the prevalence of these are essential in planning services. Previous prevalence estimates range from 44-47% for urinary incontinence (UI), 26-31% for IDC usage, and 30-40% for faecal incontinence (FI). Results of a recent New Zealand study suggest the prevalence of UI and FI among adults presenting to hospital post-stroke may be lower in the current Australasian population.
Aims: The purpose of this study was to provide updated prevalence estimates of UI, IDC usage, and FI among adults admitted to acute care after stroke.
Methods: We analysed the screening data of a prospective study (Post-stroke Incontinence Rehabilitation with Adjunct Transcutaneous Electric Stimulation; PIRATES). Included were 652 inpatients admitted consecutively during a 15-month period beginning 1 May 2021 to a single, stroke service in Melbourne, Australia. Stroke was diagnosed by a neurologist according to the ICD-11 criteria. Incontinence was evaluated by a continence nurse following the International Continence Society (ICS) definitions.
Results: Acute stroke was confirmed in 440 inpatients. The median age of stroke survivors was 76 years (IQR 66-84), 58% were male, and 76% had ischaemic stroke. The median National Institutes of Health Stroke Scale (NIHSS) score was 4 (IQR 2-12). Within the first 7 days after stroke, proportions of patients with UI, IDC, and FI were 29.1%, 6.6%, and 26.1% respectively. Among those with UI and FI, the majority (84% and 90% respectively) were continent prior to stroke.
Conclusion: Current prevalence of UI and FI among adults who received specialist stroke inpatient care may be up to 35% lower than previous estimates. IDC usage is significantly lower than previously observed. Rehabilitation for continence issues post-stroke continues to be essential.