Isolated urinary, fecal, and double incontinence: prevalence and degree of soiling in stroke survivors

Objectives: To investigate the prevalence of isolated urinary and fecal, and double incontinence in community living stroke survivors and to assess the degree of soiling. Design: Community based postal survey. Setting: 64, 749 community dwelling residents (aged 40+) living in Leicestershire (UK) were randomly selected from the Leicestershire Health Authority register. Residents living in institutional settings were excluded. Measurements: Respondents were asked about previous stroke, urinary and bowel symptoms, general health and demographic details including age, sex and ethnicity. Urinary incontinence was defined as leakage several times a month or more often. Major fecal incontinence was defined as soiling of underwear, outer clothing, furnishings or bedding several times a month or more often. Results: A 65% response rate to the postal survey was obtained with the return of 39, 519 eligible questionnaires, with 4% (n=1483) reporting stroke. Five percent of stroke survivors reported major fecal incontinence, with 4.3% reporting both fecal and urinary incontinence and 0.8% reporting isolated fecal incontinence. Major fecal incontinence was four and a half times more prevalent in stroke survivors than the non-stroke population, and stroke survivors were also twice as likely to report soiling of furnishings or bedding. The presence of fecal incontinence in both the stroke and non-stroke population is influenced by functional limitations. Conclusions Fecal incontinence is common in stroke survivors and the degree of soiling can be considerable. Future research needs to explore the impact fecal incontinence can have on the lives of stroke survivors and on how it can best be managed in those living in the community.