Abstract
New onset voiding dysfunction after a stroke is difficult problem for all persons involved in the care of those patients. We evaluated the effect of acute cerebrovascular accident on the lower urinary tract and correlated site, size and side of cerebrovascular accident with urodynamic finding. This study included 103 patients (56 male and 47 females) with acute cerebrovascular accident from September 2001 to august 2003. All patients with disturbance conscious level as mental changes or previous history of stroke were excluded from the study.as included patients were assessed neuorologically and urologically. Computerized tomography(CT) wads done for all patients.
A total f 56 patients underwent urodynamic study with electromyography within 1 week of cerebrovascular accident. Patients were divided into 5 different groups based on urodynamic findings. 59.2%of the patients had urinary symptoms and the most common symptom was incontinence (42.6%), followed by retention (41%). we found a correlation between voiding disturbance with hemiparesis (P<0.01), not with. hemianopia. urodynamic studies of 56patints revealed that 31 patients (55.4%) had detrusor hyperreflexia and 17 patients (39.1) had detrusor a reflexia. The majority of the lesions responsible for detrusor hyperreflexia were from forntoparietal region and internal capsule wheras thalamic , pontine and cerebellar lesions were associated more with detrusor hyporeflxia. There was no effect of laterality or dominance on the urinary symptom or urodynamic findings.