Incidence and outcome of poststroke urinary retention: a prospective study.

Abstract

To document the incidence and outcome of poststroke urinary retention, and to determine clinical variables associated with it. Cohort of 80 consecutive patients. Inpatient setting of a tertiary rehabilitation center. Eighty patients (48 men, 32 women; mean age, 65.4 yr) with a first ischemic stroke, admitted for rehabilitation within 4 weeks of the stroke. Patients had their postvoid residuals (PVR) assessed via a bladder scanner within 72 hours of admission. Urinary retention was defined by a PVR of more than 100mL on 2 consecutive occasions. Urinary retention was present in 23 (29%) patients. Cognitive impairment, aphasia, diabetes mellitus, and cortical stroke were present in 30%, 29%, 31%, and 41% of patients, respectively. Fifteen (19%) patients developed urinary tract infection during rehabilitation. Urinary retention was significantly associated (p < .05) with cognitive impairment, diabetes mellitus, aphasia, a lower admission functional status (as measured on the modified Barthel index), and urinary tract infection, but not with the use of anticholinergic medications. On discharge, 4 patients still had urinary retention (3 were voiding spontaneously and the other used intermittent catheterization). Urinary retention was common in patients with ischemic stroke. It should be strongly suspected in patients with aphasia, cognitive impairment, poor functional status, and diabetes mellitus.