People may have problems with the way their bladder works after a stroke. A stroke may have damage part of the brain that controls bladder function. A person may have any of these bladder problems after a stroke:
Loss of bladder control
These problems should be treated. If they are not, it can lead to infections, kidney stones or skin breakdown.
Loss of Bladder Control
Some people who have had a stroke may not be able to control their bladder. They may have frequent and sudden urges to urinate with little control. They may not be able to hold their urine long enough to get to the bathroom. This can be stressful and embarrassing if a person is not prepared.
Treatment of Loss of Bladder Control
Treatment will vary with the cause of the problem. If you have the urge to urinate but cannot make it to the bathroom on time, there are things that can help.
Bladder training: Go to the bathroom at set times. Start out going to the bathroom every 2 to 3 hours during the day. If you do not feel the urge to urinate, you should still go at the same time. This will help to train your bladder.
Sit on the commode or toilet long enough to give to empty your bladder. Do not rush.
If you feel the urge to go, do not wait. Call for help if you need someone to assist you.
Drink plenty of fluids during the day especially water.
Limit fluids at night to reduce the number of times you go to the bathroom at night.
Limit your caffeine and alcohol intake. These drinks can irritate the bladder.
Do Kegel exercises to strengthen and tone pelvic floor muscles. You can practice these by trying to stop the flow of urine while you are on the toilet. You can do them when you are sitting down or any time during the day. The more you do it, the more it will help improve bladder control.
Pads may be worn to prevent soiling of clothing. There are external catheters for men that attach to a leg bag, to prevent soiling of clothes.
Wear clothes that are easier to open.
Take care of your skin by using mild soap. Be sure to clean and dry fully.
Tell your doctor if you are having problems with control. Tests may be ordered to find the cause. Your doctor may order medicine to control the frequent and sudden urge to go.
Some people who have had a stroke may not be able to empty their bladders all the way. This can cause urinary tract infections, bladder stones, or a condition where the urine goes up into the kidneys. When the bladder does not empty, it can fill up and get stretched. This can cause the urine to leak from the overfilled bladder. This is called urinary retention.
Treatment of Urine Retention
The doctor may order some tests to find the cause. Treatment will vary with the cause. To help your doctor get started:
Tell your doctor you feel your bladder may not empty fully when you go to the bathroom.
They may use a machine called a bladder scanner to measure how much urine is still in your bladder after you go to the bathroom.
Give them a list of all the medicines you are taking. Some medicines may cause problems.
They may order medicine to help your bladder empty. Make sure you take the medicine as ordered.
Go to the bathroom and sit on the toilet or commode until you feel your bladder is empty. Do not rush.
Pads may be worn if you have a urine leak. This will prevent soiling of clothes.
If you continue to have problems, you may need a catheter to help
empty your bladder. The catheter may need to stay in or you may be taught how to insert it at scheduled times.
Symptoms of a Urinary Tract Infection
Urine that smells bad
Urine that is cloudy or dark
Fever and chills
Cramps in the lower abdomen
Pain in the lower back
Burning or pain during urination
If you have any of these symptoms, you should call your doctor. Your doctor may ask you to come in and give a sample of urine for testing. Your doctor will order medicine if needed to treat an infection.