In managing urinary incontinence after stroke, what should be reviewed as a potential contributor?

• A. Sleep position
• B. Medications that may worsen continence
• C. Diet alone
• D. Exercise only

Answer: (B)

Medications that may worsen continence are a key, modifiable factor in post-stroke urinary incontinence. When caring for someone after a stroke, it’s common to review all drugs—prescription, over-the-counter, and herbal—to see if any could be contributing to leakage or trouble emptying the bladder.

Diuretics, for example, increase urine production, which can lead to more frequent urges and leakage if the person can’t reach a toilet quickly. Anticholinergic or sedating medications can dampen bladder sensations or impair detrusor contraction and emptying, potentially causing retention or overflow and related incontinence. Other drugs that affect cognition, balance, or mobility can also make toileting less accessible, increasing leakage risk.

Because these are often reversible or adjustable with a clinician’s input, focusing on the medication list first makes sense in managing incontinence after stroke.

Options like sleep position, diet alone, or exercise only don’t address the primary, modifiable contributor as directly. While sleep quality, dietary irritants, and physical activity can influence continence, they don’t explain or fix medication-related leakage as readily as reviewing and adjusting the drugs that affect bladder function.