Incontinence hits stroke victims, but aid available

PUBLISHED : Monday, 21 June, 2010, 12:00am
UPDATED : Monday, 21 June, 2010, 12:00am

More than 12,600 elderly people a year develop urinary incontinence after suffering strokes, the Hong Kong Geriatrics Society estimates, based on the results of a survey.

Among 1,159 stroke patients polled last year between February and May in 13 public hospitals, 63.1 per cent were not able to control their urge to go to toilet. This compared with 12.8 per cent with the problem before their stroke.

The society said yesterday the survey was the largest of its type carried out in the world, and the first in Asia to study the relationship between stroke and urinary incontinence.

Of the stroke patients who did not have urinary problems, only 13.1 per cent needed to stay in homes for the elderly, but the percentage for those with incontinence was 42.7 per cent.

The death rate of those with incontinence was 4.8 per cent, much higher than the 1.2 per cent among those without.

Survey leader Dr Edward Leung Man-fuk, a specialist in geriatrics, said about 20 per cent of patients suffering from urinary incontinence would need to wear plastic collection tubes, urinary catheters, for the rest of their lives.

He said the condition greatly affected the social lives of elderly people. 'They use perfume or wear dark colours to hide their urine, or they avoid going out altogether,' he said.

But geriatrician Tong Bing-chung said incontinence could improve over time - on average, 20 to 30 per cent of patients could improve without treatment, and 60 per cent of cases could be cured with treatment.

Tong said treatment options included toilet training, such as setting a regular timetable for urination, and training the bladder to increase its capacity.

Patients could also be taught how to relax and contract muscles to control the urge to urinate.

Other treatment options included permanent and temporary urinary catheters, he said.

Tong would not recommend using diapers, as that 'would not provide a genuine solution'.

'Wearing diapers would make senior citizens feel that they were like babies, or they would not have the motivation to improve their incontinence,' he said.

Stroke is the No 4 killer in the city, after cancer, heart disease and pneumonia.

More than 20,000 stroke patients seek help from public hospitals each year, and more than 3,000 die.

As the population ages, it has been estimated that stroke patients will increase by 50 per cent in the coming five years.

Troubled waters

Elderly patients can be taught how to control the urge to urinate

The proportion of patients suffering stroke-related urinary incontinence who can be cured with treatment: 60%