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Varna Medical Forum

Micturition disorders after stroke

Darina Georgieva-Hristova


The bladder gets as somatomotor and vistseromotorna parasympathetic innervation. Urinary incontinence, and other disorders of urination function are common complications in patients with cerebrovascular disease. Significant urination disorders affect the quality of life of the patient, and its mortality. The prevalence of urinary incontinence early after stroke varies znachiterlno from 41% to 83%. Furthermore, there is no uniformity in terms of the type of functional impairment. The majority of surviving a stroke have a dysfunction of the detrusor muscle (hyperreflexia or hyporeflexia) as nocturia is among the most commonly reported disorders after stroke. Older age, female sex, the presence of incontinence before the onset of the stroke, and the greater severity of the stroke, are associated higher incidence of urinary incontinence.


stroke, incontinence, urinary dysfunction

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Мавлов Л „Фундаментална неврология”, 2000;87-88.

L. Birder, W. de Groat, I. Mills, J. Morrison, K. Thor, and M. Drake.. Neural Control of the Lower Urinary Tract: Peripheral and Spinal Mechanisms Neurourol Urodyn. 2010; 29(1): 128–139

de Groat WC, Booth AM, Yoshimura N, et al. Neurophysiology of micturition and its modification in animal models of human disease. In: Maggi CA, editor. The autonomic nervous system, Vol. 3, Chapter 8, Nervous control of the urogenital system. Harwood Academic Publishers; London, UK: 1993. pp. 227–89.

Woock JP, Yoo PB, Grill WM. Activation and inhibition of the micturition reflex by penile afferents in the cat. Am J Physiol. 2008;294:R1880–90

Gustafson KJ, Creasey GH, Grill WM. A urethral afferent mediated excitatory bladder reflex exists in humans. Neurosci Lett. 2004;360:9.

Drake, M.J., Fowler, C.J., Griffiths, D., Mayer, E., Paton, J.F., Birder, L. Neural control of the lower urinary and gastrointestinal tracts: supraspinal CNS mechanisms. Neurourol. Urodyn. 2010;29:119-127.

Holstege, G. The emotional motor system and micturition control. Neurourol. Urodyn. 2010;29:42-48.

de Groat, W.C., Wickens, C. Organization of the neural switching circuitry underlying reflex micturition. Acta Physiol. (Oxf.). 2013;207:66-84..

Brindley GS. The first 500 patients with sacral anterior root stimulator implants: General description.Paraplegia. 1994;32:795-805

Vizzard MA, Erdman SL, Forstermann U, et al. Differential distribution of nitric oxide synthase in neural pathways to the urogenital organs (urethra, penis, urinary bladder) of the rat. Brain Res. 1994;646:279-91.

Dering MA, Santer RM, Watson AH. Age-related changes in the morphology of preganglionic neurons projecting to the paracervical ganglion of nulliparous and multiparous rats. Brain Res. 1998;780:245-52

Scand J Urol Nephrol Suppl. 2002;(210):16-20.Possible pathways for cerebellar modulation of autonomic responses: micturition.Dietrichs E1, Haines DE

Zhang H, Reitz A, Kollias S, Summers P, Curt A, Schurch B. volume 24, issue 1an fmri study of the role of suprapontine brain structures in the voluntary voiding control induced by pelvic floor contraction, 2005, pages 174-180

Abrams P, Cardozo L, Fall M, et al The standarization of terminology of lower urinary tract function: report of the standardisation Sub-committee of the International Continence Society.International Continence Society . Neurourol Urodyn 2002;21:167-78

Abrams P, Artibani W, Cardozo L, et al. International Continence Society. Reviewing the ICS 2002 terminology report: the ongoing debate. Neurourol Urodyn 2006;25:293].

Linsenmeyer TA Post-cva voiding dysfunctions: clinical insights and literature review. NeuroRehabilitation. 2012;30(1):1-7

Sandvik H, Hunskaar S, Seim A, Hermstad R, Vandik A, Bratt H. Validation of a severity index in female urinary incontinence and its implementation in epidemiological survey. J Epidemiol Community Health. 1993;47:497-499.

Brittain KR, Peet SM, Castleden CM. Stroke and incontinence. Stroke. 1998 Feb;29(2):524-8

Williams MP1, Srikanth V, Bird M, Thrift AG Urinary symptoms and natural history of urinary continence after first-ever stroke--a longitudinal population-based study. Age Ageing. 2012 May;41(3):371-6.

Korpelainen JT, Sotaniemi KA, Myllylä VV. Autonomic nervous system disorders in stroke. Clin Auton Res. 1999 Dec;9(6):325-33

Gelber DA, Good DC, Layven LJ, Verhulst SJ. Causes of urinary incontinence after acute hemispheric stroke. Stroke. 1993;24:378-382

Tibaek S, Gard G, Klarskov P, et al. Prevalence of lower urinary tract symptoms (LUTS) in stroke patients: a cross-sectional, clinical survey. Neurourol Urodyn 2008;27:763-71

Nakayama H, Jørgensen HS, Pedersen PM, Raaschou HO, Olsen TS. Prevalence and risk factors of incontinence after stroke: the Copenhagen stroke study. Stroke. 1997;28:58-62.

Kolominsky-Rabas PL, Hilz Mj, Neundoerfer B, et al. Impact of urinary incontinence after stroke: results from a prospective population-based stroke register. Neurourol Urodyn 2003;22:322-7.

Burney TL, Senapati M, Desai S, Choudhary ST, Badlani GH.J Urol. 1996 Nov;156(5):1748-50.Acute cerebrovascular accident and lower urinary tract dysfunction: a prospective correlation of the site of brain injury with urodynamic findings.

Sakakibara R, Hattori T, Yasuda K, Yamanishi T. Micturitional disturbance after acute hemispheric stroke: analysis of the lesion site by CT and MRI. J Neurol Sci. 1996 Apr;137(1):47-56

Andrew J, Nathan PW. Lesions of the anterior frontal lobes and disturbances of micturition and defaecation. Brain. 1964;87:233-262

Burney TL, Senapati M, Desai S, Choudhary ST, Badlani GH. Effects of cerebrovascular accident on micturition. Urol Clin North Am. 1996;23:483-490


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