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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What are the symptoms of a stroke?

Symptoms of stroke vary greatly, and it is crucial to judge based on the circumstances. The symptoms are mainly divided into two major categories: hemorrhagic stroke and ischemic stroke. The most common symptoms of hemorrhagic stroke are severe headaches, projectile vomiting, and the gradual onset of consciousness disorders. Some people might also experience limb numbness, weakness, speech impediments, and other conditions. The most common symptoms of ischemic stroke include dizziness, limb numbness, and speech impediments; sometimes, these symptoms alternate, so it is essential to pay attention to clinical observations and focus on differential diagnosis. There are also other types of symptoms, such as cognitive decline, urinary and fecal incontinence, unstable gait, swallowing difficulties, and coughing while swallowing. Therefore, it is imperative to visit a hospital in a timely manner for testing to clearly understand the specific changes in the patient's condition at that time, thus better facilitating the patient’s recovery.

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Stroke and Its Treatment

Stroke primarily refers to cerebrovascular disease, characterized by the sudden onset of symptoms that develop within minutes. This rapid development of symptoms is why it is called a stroke. Stroke commonly affects middle-aged and elderly people who often have certain risk factors. For example, high blood pressure, high blood cholesterol, smoking, drinking, obesity, and heart diseases like atrial fibrillation can increase the risk of stroke. For the treatment of stroke, it is crucial to reach the hospital as soon as possible, as earlier treatment leads to better outcomes. Generally, if it is suitable, the patient may receive intravenous thrombolysis. Additionally, treatment may involve anti-atherosclerosis measures, nutritional support for nerves, and rehabilitation training, which is also very important.

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What is the goal of rehabilitation during the acute phase of a stroke?

Rehabilitation goals during the acute phase of stroke. In the acute phase, we usually can intervene with rehabilitation treatment 48 hours after the patient’s vital signs have stabilized. The main goals of rehabilitation during the acute phase are to prevent complications such as pressure ulcers, atelectasis pneumonia, urinary tract infections, deep vein thrombosis, and muscle atrophy. Additionally, it aims to improve impaired neurological functions such as sensory, motor, and speech therapies, and to enhance the patient’s ability for self-care and mobility.

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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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Rehabilitation nursing for stroke patients

For the rehabilitation and nursing care of stroke patients, first and foremost, we need to monitor the patient's vital signs, food intake, sleep, as well as bowel and bladder function. Secondly, we should pay attention to their psychological state, checking for signs of tension, anxiety, and depressive emotional reactions. Thirdly, we encourage patients to overcome their illness and to establish confidence in their recovery. Fourthly, we guide patients to actively engage in physical function exercises, as well as daily activities such as eating and dressing to practice their daily living skills. Fifthly, we manage proper limb positioning and patient turning, prevent pressure sores, and also prevent a series of complications such as venous thrombosis and urinary tract infections.