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Detrusor hyperreflexia in strokes

K H Kong1, K F Chan, A C Lim

  • 1Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore.

Annals of the Academy of Medicine, Singapore
|May 1, 1994
PubMed
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Cerebrovascular accidents can cause bladder dysfunction. Detrusor hyperreflexia, often linked to urge incontinence, was observed in 40.7% of patients post-stroke, impacting bladder capacity.

Area of Science:

  • Neurology
  • Urology
  • Rehabilitation Medicine

Background:

  • Cerebrovascular accidents (CVAs) frequently lead to neurological deficits affecting various bodily functions.
  • Urinary dysfunction, including incontinence and altered bladder sensation, can be a significant post-stroke complication.
  • Urodynamic evaluation is crucial for assessing bladder function and identifying underlying mechanisms of urinary symptoms.

Purpose of the Study:

  • To investigate the prevalence and characteristics of bladder dysfunction in patients following cerebrovascular accidents.
  • To correlate urodynamic findings with the presence and type of urinary symptoms.
  • To determine the predictive value of specific symptoms, such as urge incontinence, for urodynamic abnormalities.

Main Methods:

  • Urodynamic evaluation using water cystometry was performed on 27 patients between 12 and 120 days post-CVA.

Related Experiment Videos

  • Patients were assessed for urinary symptoms, including urge incontinence, frequency, and incomplete bladder emptying.
  • Bladder function was categorized into normal, detrusor areflexia, and detrusor hyperreflexia.

    • Main Results:

    • Detrusor hyperreflexia was identified in 40.7% of patients, while 3.7% exhibited detrusor areflexia, and 55.6% had normal bladder function.
    • Among patients with detrusor hyperreflexia, 54.5% were asymptomatic, and 45.5% presented with urge incontinence.
    • Patients with detrusor hyperreflexia and urge incontinence showed significantly lower first sensation and functional cystometric capacity compared to asymptomatic hyperreflexic patients. Urge incontinence accurately predicted detrusor hyperreflexia.

    Conclusions:

    • Detrusor hyperreflexia is a common urodynamic finding in the subacute phase after cerebrovascular accidents.
    • Urge incontinence is a reliable clinical indicator of detrusor hyperreflexia in post-stroke patients.
    • Bladder dysfunction, particularly detrusor hyperreflexia, can impact bladder capacity and sensation, necessitating urodynamic assessment for effective management.