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

OBJECTIVES: To investigate the prevalence of isolated urinary and fecal incontinence and double incontinence in community-living stroke survivors and to assess the degree of soiling. DESIGN: Community-based postal survey. SETTING: Leicestershire, United Kingdom. PARTICIPANTS: Sixty-four thousand seven hundred forty-nine community-dwelling residents (aged > 40) 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, and 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; 4% (n = 1,483) reported stroke. Five percent of stroke survivors reported major fecal incontinence, with 4.3% reporting fecal and urinary incontinence and 0.8% reporting isolated fecal incontinence. Major fecal incontinence was four and a half times as prevalent in stroke survivors as in the nonstroke population, and stroke survivors were also twice as likely to report soiling of furnishings or bedding. Functional limitations influence the presence of fecal incontinence in the stroke and nonstroke population. CONCLUSION: Fecal incontinence is common in stroke survivors, and the degree of soiling can be considerable. Future research needs to explore the effect fecal incontinence can have on the lives of stroke survivors and on how it can best be managed in those living in the community.