How Do Stroke
Affect Your Bladder: Urinary Retention, Frequency, and Incontinence

Published 2019/10/03

In the United States, a stroke occurs every 40 seconds. Survivors of stroke often need to navigate the long-term effects stroke has left on their bodies, one of them being bladder dysfunction. 


This article explains how stroke causes bladder dysfunctions, the types of bladder dysfunctions—retention, frequency, and incontinence, as well as treatments for bladder dysfunctions. 

First, Some Fast Facts
on Stroke

There are two types of strokes, ischemic stroke, and hemorrhagic stroke.


The ischemic stroke is the more common one, and it occurs when a blood clot blocks a blood vessel in the brain, causing brain cells to quickly die from the lack of blood circulation and oxygen, which in turn causes the body to lose some neurological functions. The ischemic stroke can also occur when plaque builds up inside an artery, causing it to narrow and eventually become blocked.


If you have suffered a mini ischemic stroke (transient ischemic stroke), you are at risk of suffering a more serious one.


Hemorrhagic stroke is the second type, and it happens when the blood vessel bursts or leaks. 


In the United States, stroke is the fifth leading cause of adult death and disability, and nearly 800,000 people experience strokes each year. 


These conditions (among others) can make you more at risk of stroke: diabetes, heart disease, obesity, and high cholesterol level. 

How does a stroke affect
your bladder?

Since a stroke causes neurological damage to the body, the nerves that control the bladder can also be damaged.


Nerves play a big role in the process of urination. When you urinate, the nerves that control the bladder trigger the bladder’s detrusor muscle to contract and push urine into the urethra, and the nerves also signal to the urethral sphincters to relax and let urine flow out of the body. When you are not urinating, the nerves signal the detrusor muscle to relax and the sphincter to contract to keep the urine in.


After a stroke, nerves controlling the bladder can be damaged. Because nerves can no longer properly signal to the bladder, this can lead to frequent urination (urinary frequency), inability to hold in urine (urinary incontinence), sudden urge to urinate (urinary urgency) or inability to urinate (urinary retention). 

How to treat stroke-related
bladder dysfunctions?

For urinary frequency, urinary incontinence, and urgency, the doctor may prescribe you with medicine and/or physical therapy such as pelvic floor exercises and bladder training


Pelvic floor exercises like Kegel strengthens the muscles that support the bladder, giving you greater control over your bladder.


Bladder training is about sticking to a set schedule for bathroom trips and resisting the urge to urinate outside of that schedule. Overtime, bladder training can increase the volume of fluid your bladder can hold, resulting in fewer bathroom trips and diminished feelings of urinary urgency.


For urinary retention (when you can’t urinate), the doctor may prescribe you with medicine or a catheter, which is inserted into the bladder through the urethra to help draw urine out. 


For people who are bed-ridden or otherwise unable to move, the doctor may prescribe an indwelling catheter. For others, an intermittent catheter is prescribed. Usually, a stroke survivor only needs a catheter temporarily while recovering, but sometimes, their condition requires them to use a catheter long-term.

Tips on Dealing with
Bladder Dysfunction after Stroke

If you find it hard to walk or coordinate movements after stroke, you can 

  • Ask someone to help you to the bathroom (especially if you’re in a rush)
  • Install raised toilet seats, which adds extra height to the toilet and provides handles to hold on to while you sit down or get up
  • Install rails on the wall in bathrooms at home, and use handicap bathrooms in public
  • Place commode chairs by your bedside 

If you are experiencing leakage, you can

  • Bring portable urine bottles
  • Wear pads, liners, and absorbent underclothing
  • Use mattress protectors and water-resistant covers and bedsheets

If you have trouble urinating and trouble voiding completely (urinary retention)

  • Use your hand to press down on the bladder to help get the urine out
  • Double voiding: after going once, go again in 10-15 minutes to empty your bladder more completely 
  • Scheduled voiding: urinating at regular intervals to prevent build-up
  • Use a catheter (need to have a prescription)—here is a comprehensive guide on how to find the best catheter. The guide covers important topics like portability, discretion, user’s dexterity level, infection risks, catheter size, and shape of the catheter tip. 

Untreated urinary retention can increase your risk of having a UTI, bladder infection, bladder damage (from bladder being stretched out), kidney infection, and kidney failure. Therefore, it is important for you to treat it seriously and closely follow your doctor’s advice.

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