People may have problems with the way their bladder works after a stroke. This occurs because the stroke has damaged a part of the brain that controls bladder function. Some people report they are not able to control the bladder the way they once could. Others have trouble with getting the bladder to empty, so they feel that they have to go more often. 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 function. They may have frequent and sudden urges to urinate with little control of their bladder. Often, they are not 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 treatment options that can be put in place to help.

  • 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 scheduled time. This will help to train your bladder.

  • Sit on the commode or toilet long enough to give yourself time 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 to the bathroom.

  • Drink plenty of fluids during the day. Limit the amount of fluids at night to help reduce the number of times you have to go to the bathroom at night.

  • Limit your caffeine and alcohol intake.

  • 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. After you have practiced this to get the feel of it, you can do it any time during the day, even when you are sitting at your kitchen table, or brushing your teeth. The more you do it, the more it will help.

  • 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.

  • Tell your doctor if you are having problems with control of your bladder. Tests may be ordered to find the cause. At times, your doctor may order medicine that may help to control the frequent and sudden urge to urinate.

Urinary Retention

Some people who have had a stroke may not be able to empty their bladders completely when they go to the bathroom. 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. Doctors call this urinary retention.

Treatment of Urinary 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 that you feel your bladder may not empty fully when you go to the toilet.

  • The doctor or nurse 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 your doctor a list of all the medicines you are taking. Some medicines may cause problems.

  • The doctor may order medicine to help your bladder empty. Make sure you take the medicine as the doctor ordered.

  • Go to the bathroom and sit on the toilet or commode until you feel your bladder is empty. Remember not to rush.

  • Pads may be worn if you have a urine leak. This will prevent soiling of clothes. 

  • If you continue to have problems with urine retention, 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

  • Frequent urination

  • Burning or pain during urination

If you think you may have 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 antibiotics if needed to treat an infection.