Stroke and lower urinary tract symptoms: A neurosurgical view

Abstract

Lower urinary tract symptoms (LUTSs) are common neurological sequelae of stroke, which negatively impact the mortality of patients with stroke and the quality of life of both patients and their caregivers. There are three hierarchical micturition centers: the sacral spinal center, subconscious structures, and conscious structures. Several brain imaging modalities for micturition studies on humans and animals and neuroanatomical studies on animals have facilitated a better understanding of LUTSs. The urodynamic findings in patients with stroke may vary and tend to evolve with time; the identification of the underlying cause of poststroke voiding dysfunction helps optimize the management of these patients. For patients with stroke with overactive bladders, the first-line treatments include behavioral therapies and the second-line therapies include the use of drugs. Intermittent or indwelling catheterization can be used for patients with stroke with detrusor underactivity. In this article, we discuss the current consensus, relevant assessment modalities, and management of LUTSs in patients with stroke.

Keywords

• Lower urinary tract symptoms
• neurogenic voiding
• neuroimaging
• urodynamic detrusor overactivity