In the acute phase, or if a patient is acutely unwell, it may not be possible or appropriate to do a full bladder and bowel assessment. It should also be remembered that sometimes new onset bladder and bowel problems resolve spontaneously.
Assessment of bladder and bowel dysfunction, select the crosses for more information
Assessment of bladder and bowel dysfunction
Effects of stroke – Assess activities associated with bladder and bowel function: mobility, manual dexterity, vision, personal care needs, cognition (for understanding, perception and planning), communication (to comprehend and express need), swallow (fluid intake).
Bladder and bowel symptoms – Assess previous symptom history and management, new symptoms and how bothersome the person finds them.
Environment – Assess for effects of hospital environment on continence. Assess needs for home/discharge destination
Investigations –
- Urinalysis to detect possible infection and medical complications
- Post void residual urine measurement (bladder scanner or in/out catheter) to identify any incomplete bladder emptying and urinary retention
- Bowel dairy to establish bowel patterns of voiding, bladder capacity, frequency of micturition
- Fluid balance chart to establish patterns of voiding, bladder capacity, frequency of micturition and type of fluid intake.
Physical examination – This should be carried out by trained staff according to local policy.
- Bladder palpation to identify retention
- Abdominal examination for masses
- Rectal examination to identify prostate enlargement, rectal problems, constipation and faecal loading
- Vaginal examination to identify atrophic vaginitis, pelvic organ prolapse and condition of pelvic floor
Quality of life questions – Assess family network, social activities and hobbies, employment history to build holistic picture of the person.
The patient – Assess patient biography and history – person-centred approach.
Page last reviewed: 31 Jan 2022
