Article

Persistence of urinary incontinence post acquired brain injury (ABI)
carries important prognostic significance. We undertook to document the incidence
of urinary incontinence, its management and complications in rehabilitation
inpatients following ABI and to assess adherence to post ABI bladder management
guidelines. METHOD: A retrospective chart survey of a convenience sample of
consecutive admissions to two adult neurorehabilitation units Forster Green
Hospital, Belfast, and the Scottish Brain Injury Rehabilitation Service,
Edinburgh (SBIRSE). Bladder continence and management on transfer to and
discharge from rehabilitation, trial removal of catheter, use of bladder drill,
ultrasound investigation, anticholinergic medication and complications were
recorded. RESULTS: One hundred and forty six patients were identified.
Seventy-seven (52.7%) were independent and continent of urine at rehabilitation
admission and 109 (74.7%) on discharge. In all, 13 patients had urinary tract
infection, 7 had urethral stricture and 1 developed haematuria whilst
catheterised. Ultrasound of renal tracts was underused. Trial removal of catheter
after transfer to rehabilitation occurred at a median of 10 days. CONCLUSIONS:
Urinary continence was achieved in almost half of incontinent ABI patients during
rehabilitation. There is potential for increased use of investigation of the
renal tracts. Rehabilitation physicians should consider urethral stricture in the
management of continence post ABI.

Langue : ANGLAIS