Lower Urinary Tract Dysfunction in Stroke Patients
摘要
OBJECTIVE: This study investigated the association between different types of stroke and the associated lower urinary tract dysfunction (LUTD). MATERIALS AND METHODS: In total, data on 170 stroke patients with LUTD from 1997 to 2006 were collected. Patients with preexisting urologic disease were excluded. Lower urinary tract symptoms (LUTSs) of these patients were recorded and a videourodynamic study (VUDS) was performed on every patient. The patients were categorized into hemorrhagic and ischemic stroke groups according to the disease and were grouped into supratentorium and infratentorium groups according to the location of the lesion. The LUTS and VUDS findings were compared between different stroke groups. In addition, patients whose stroke had occurred more than 12 months previous were also compared to those whose stroke had occurred within the past 12 months. RESULTS: The main LUTSs in the ischemic stroke group were urgency (48%) and incontinence (47.1%), followed by urinary retention (33.3%). In the hemorrhagic stroke group, urinary retention was noted in 45.6%, urinary incontinence in 16.8%, and urgency in 29.4% of patients. Urgency was more commonly found in the ischemic than in the hemorrhagic stroke group (p＜0.05). Detrusor overactivity was found in 71.6% and 69.1% while a coordinated urethral sphincter was found in 71.6% and 61.8% of patients with ischemic and hemorrhagic stroke, respectively. The LUTS and urodynamic findings were similar between patients with a supratentorial stroke and those with an infratentorial stroke. The most common presenting LUTSs in patients whose stroke had occurred ＞12 and ≤12 months previous were urgency (53.9%) and urine retention (45.7%), respectively. Significantly more patients whose stroke had occurred ≤12 months previous (77.7%) had urodynamic detrusor overactivity than those whose stroke had occurred ＞12 months previous (61.8%). CONCLUSIONS: Detrusor overactivity was commonly found in both ischemic and hemorrhagic s