Treatment of urinary retention in stroke patients

Written by Tang Ying
Physical Medicine and Rehabilitation
Updated on September 09, 2024
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In cases of urinary retention after a stroke, some patients experience this due to psychological factors, concerns, and the sudden need to remain in bed, making it difficult to urinate in bed since they cannot stand or squat. Therefore, the first step is to alleviate psychological factors, provide patient communication and counseling, and perform massages around the navel and abdomen, along with heat treatments, to help patients urinate on their own. In a second scenario, where the patient's condition is severe or even comatose, and they have difficulty urinating, a catheter can be placed. It's important to first try to rule out a urinary tract infection, collect a midstream urine sample for analysis, and ensure the catheter is not left in longer than necessary. Once the patient's condition improves or they regain consciousness, the catheter should be removed promptly to avoid any urinary tract infections.

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Causes of Dysphagia after Stroke

The causes of dysphagia resulting from a stroke are largely related to the location of the stroke. Dysphagia mainly involves the glossopharyngeal and vagus nerves, which are distributed in the medulla oblongata of the brainstem. Therefore, if you have a brainstem stroke, specifically at the medulla oblongata, there is a significant chance of experiencing coughing due to aspiration and dysphagia. If the stroke occurs in a different area, these symptoms are unlikely to appear. A stroke in the cerebral hemisphere, since it has bilateral nerve supply, does not lead to noticeable coughing if only one side is affected. However, if one side is affected this year and the other side next year, similar symptoms of aspiration cough and dysphagia will occur. Therefore, neurologically, the location and specific site of the stroke are crucial, as each location presents different symptoms.

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Post-stroke depression

Recent studies have confirmed that in addition to language dysfunction, cognitive impairment, and motor dysfunction, stroke patients also exhibit many signs of depression. According to guidelines published in China in 2016, about 33% of stroke patients experience post-stroke depression, which is a very high proportion. The main symptoms of post-stroke depression include a lack of interest in anything, unwillingness to communicate with others, being quiet and reticent, non-compliance with medication, and non-cooperation with rehabilitation training. Post-stroke depression significantly affects the recovery of patients and their future quality of life. Some patients may even turn to suicide due to depression. Therefore, it is crucial to pay attention to depression after a stroke, as the incidence rate of post-stroke depression is very high, reaching up to 33%. Clinicians must carefully identify it, and family members of patients must be attentive in their care.

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The difference between stroke and cerebral hemorrhage

Stroke includes hemorrhagic stroke and ischemic stroke. Hemorrhagic stroke refers to cerebral hemorrhage, and ischemic stroke refers to cerebral infarction. Thus, they are included in the category of stroke. If symptoms similar to stroke occur, such as facial droop and limb weakness, along with a sudden increase in blood pressure, it is essential to go to the hospital immediately. The first step should be a cranial CT scan to determine whether it is a hemorrhagic or ischemic stroke, to guide further different treatments. Therefore, one must go to the hospital promptly if such symptoms appear.

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What are the symptoms of a stroke?

Stroke, also commonly referred to as cerebrovascular accident, is caused by the rupture or blockage of blood vessels within the skull, leading to necrosis of brain tissue and a series of symptoms. It is divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke, commonly known as cerebral infarction or stroke, while hemorrhagic stroke refers to cerebral hemorrhage. Generally, ischemic strokes account for 80% of cases. Ischemic stroke is caused by blockage of blood vessels leading to necrosis of brain tissue, presenting with a series of symptoms such as hemiplegic numbness. Cerebral hemorrhage results from rupture of brain blood vessels causing damage to brain cells and symptoms of compression, and may also present with symptoms such as hemiplegic numbness. Both types can be differentiated by their symptoms, and can also be definitively diagnosed through a CT scan.

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Is a stroke a cerebral infarction?

Stroke includes cerebral infarction. Stroke is divided into ischemic stroke and hemorrhagic stroke. Therefore, ischemic stroke is cerebral infarction, and hemorrhagic stroke is cerebral hemorrhage. Thus, one cannot say it is solely a cerebral infarction; it includes cerebral infarction. If symptoms of stroke appear, such as unclear speech or limb weakness, it might be either hemorrhagic or ischemic stroke. In such cases, it is crucial to seek medical attention immediately. For hemorrhagic stroke, one should visit the neurosurgery department, and for ischemic stroke, the neurology department is appropriate. Initially, a CT scan should be performed to make a clear diagnosis.