Urinary incontinence after traumatic brain injury: incidence, outcomes and correlates

Objectives: To document the incidence and outcome of urinary incontinence (UI) and urinary retention (UR) during acute traumatic brain injury (TBI) rehabilitation and determine associated clinical variables. Methods: Retrospective case series. Results: Eighty-four patients (mean age 44.7+/-17.9 years; 66 males, 18 females) with first-ever TBI within 6 weeks of injury. On admission, UI was present in 52 (62%). UR defined as post-void residual urine volumes of >100 mls was present in eight (9.5%). Forty-six (54.8%) needed external collecting devices and six (7.1%) used indwelling catheters. Bilateral lesions, diabetes mellitus and faecal impaction were present in 70.2, 10.7 and 6.0%, respectively. UI was associated with poorer functional status (measured by the modified Barthel index) and presence of bilateral lesions (p<0.01). UR was associated with diabetes mellitus and faecal impaction (p<0.01). On discharge, 31 (36.9%) remained incontinent. Conclusion: UI is common after acute TBI and is associated with poorer functional outcome.