Management of lower urinary tract dysfunctions in patients after stroke

Details

Supervisors

HANSON, PHILIPPE

Faculty

Faculté des sciences de la motricité

Degree label

Master [60] en kinésithérapie et réadaptation

Abstract

Objective: The aim of this review of the literature is to present the existing treatments of lower urinary tract dysfunctions in patients after stroke. Method: equations of research were put into the databases Scopus, Cochrane, Pubmed and Science Direct. 1456 articles were obtained, and 16 articles corresponded to the inclusion criteria. Results: 3 articles talked about botulinum toxin injection, 7 about pelvic floor muscle training (PFMT), 3 about transcutaneous electrical nerve stimulation (TENS), and 3 about different techniques of acupuncture. Botulinum toxin injection improved detrusor sphincter dyssynergia and detrusor overactivity although in the latter, post-void residual volume (PVR) increased. PFMT program helped to reduce urine leakage, lower urinary tract symptoms (LUTS), frequency of voiding, and pelvic floor muscles strength, endurance and function. TENS improved self-care in activities of daily living, urodynamic variables, and LUTS. It seems that a 20 Hz frequency showed the best results. Electroacupuncture in the treatment of urinary retention in the acute phase improved the PVR ratio but needs to be further investigate given the lack of methodological quality. Electroacupuncture compared with sham electroacupuncture significantly reduced detrusor overactivity. Conclusion: the lack of inter-study comparisons, large samples and standardised outcomes makes difficult the establishment of practice guidelines. Further research comparing the techniques is needed.