Urinary Disorders in Subacute Patients After Stroke

Study Overview
=================
Brief Summary
-----------------
This observational study will address urinary disorders in subacute stroke patients. Patients without and with urinary disorders will be compared, and treatment outcome will be assessed among the latter.

Detailed Description
-----------------
This prospective observational study will include 100 patients after first ischaemic or hemorrhagic stroke directly transferred from an acute hospital to our Institute for inpatient rehabilitation. Within admission assessment, patients will be classified according to stroke type, stroke localisation and time since stroke. Comorbidities will be recorded and associated neurological deficits will be assessed. Post mictional residue will be determined in all patients one day after admission. The patients with urinary disorders will be treated according to the published official protocol, either using the immediate urination approach or the bladder diary approach. Continence will be regularly assessed by the nursing staff. Urination-disorder-related complications (pressure ulcers, falls and urinary infections), drug therapy and the use of continence aids will also be followed.

Official Title
-----------------
Assessment and Treatment of Urinary Disorders in Patients in the Subacute Phase After Stroke

Conditions
-----------------
Stroke, Ischemic, Stroke Hemorrhagic, Urinary Incontinence

Intervention / Treatment
-----------------
* Behavioral: Immediate urination
* Behavioral: Bladder diary


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: subacute patients after ischaemic or hemorrhagic stroke; direct transfer from acute hospital to complex inpatient rehabilitation at our Institute. Exclusion Criteria: incontinence before stroke; previous brain injury or other brain disease; previous bladder or prostate surgery; inability to ambulate before stroke; terminal disease with expected survival less than three months.
Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Without urinary disorders<br>Subacute stroke patients without urinary disorders | |
| With urinary disorders<br>Subacute stroke patients with urinary disorders | Behavioral: Immediate urination<br>* Patients with decreased cognitive ability will be taught to immediately go to the toilet upon feeling the urge to urinate and to be independent in urinating.<br>Behavioral: Bladder diary<br>* Patients with normal cognitive abilities will be instructed to go to the toilet every 2-3 hours regardless of the urge to urinate<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Degree of urinary continence | Urinary continence will be assessed daily by the nursing staff as either complete, partial or incontinence | Through study completion, for an average of 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence of urinary-disorders-related complications | Pressure ulcers, falls and urinary infections caused by urinary disorders will be recorded | Through study completion, for an average of 6 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
stroke, inpatient rehabilitation, urinary disorders, treatment