Voiding Dysfunction after Stroke and Traumatic Brain Injury: Multi-center Study

ABSTRACT

OBJECTIVE: Voiding dysfunction after stroke and traumatic brain injury has been known to be a predictive factor of death or severe disability, and an important factor on hospital discharge. Thus we aim to investigate its prevalence, related factors and natural course of brain injury related voiding dysfunction for proper rehabilitation after brain injury. METHOD: Two hundred ten brain injury patients (male 130, female 80) admitted in 5 university hospitals were included. The cognitive function was assessed using the Korean version-Mini mental state examination (K-MMSE), and bladder function was evaluated with the International Prostate Symptom Score (IPSS) and voiding diary. We excluded the patients that had previous urologic and gynecologic problem. RESULTS: Overall, 43.7% of total patients had voiding difficulty and the most common symptom was nocturia (80.6%), which was followed by frequency (72.6%) and urgency (40.3%). Patients with incontinence had lower K-MMSE scores than continent patients. There was no significant difference of rate of incontinence in relation with sex, cause of brain injury, and lesion site. Prevalence of urinary symptoms decreased as the duration after brain injury was longer. The quality of life score showed a high correlation with the total IPSS score (p<0.05). CONCLUSION: The overall results demonstrate that voiding dysfunction after brain injury is influenced by onset time and cognitive function after brain injury.