Correlation between ischemic stroke topography and female urinary incontinence

Aim: To investigate the association between ischemic stroke topography and the onset of urinary incontinence (UI); to evaluate predictors of post-stroke UI in women.

Method: We prospectively followed up a cohort of women with ischemic stroke confirmed by clinical and computed tomography (CT) or magnetic resonance imaging (MRI) scans findings. Participants were subjected to interview, clinical evaluation, and urodynamic study if needed at 6 months post-stroke and divided in continent and incontinent groups. Non-parametric tests compared the baseline characteristics among the groups and determined association between post-stroke UI and the brain sites of injury. Logistic regression analysis determined predictors of post-stroke UI. Significance level at 5 % was set.

Results: 162 S-women were included: 128 (79 %) continent and 34 (21 %) incontinent. Frontal lobe lesions were higher in the incontinent group (82.9 % versus 51.2 %, p = 0.001); lesions in the parietal lobe and the left cerebral hemisphere were higher in the continent group (40.9 % versus 20 %, p = 0.023; and 61.4 % versus 40 %, p = 0.024, respectively). Frontal lobe injury [RR 3.68 (CI 1.2-11.2)], body mass index (BMI) [RR1.16 (CI 1.062-1.266)] and number of vaginal deliveries [RR 1.358 (CI 1.163-1.585)] are risk factors for post-stroke UI. Left parietal lobe injury is less likely to occur in continent women after 6 months [RR 0.168 (CI 0.029-0.981; p = 0.048)].

Conclusion: There is a correlation between the topography of the ischemic stroke and the onset of UI. Frontal lobe lesion, BMI and number of vaginal deliveries are predictors of post-stroke UI.