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ICONS II: Identifying Continence Options after Stroke

ICONS II is a randomised controlled trial to compare the effectiveness and cost-effectiveness of a systematic voiding programme with usual care in reducing the severity of urinary incontinence in patients with stroke.

Expertise and Subject area

Project Lead/Contact

Dr Lois Thomas,

Collaborators and Partners

  • Professor Christine Roffe, University Hospitals of North Midlands NHS Trust; Keele University
  • Professor Bruce Hollingsworth, Lancaster University
  • Dr Céu Mateus, Lancaster University
  • Dr Kina Bennett, Lancashire Teaching Hospitals NHS Foundation Trust
  • Professor Joanne Booth, Glasgow Caledonian University
  • Professor Christopher Chapple, Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield University;  Sheffield Hallam University
  • Dr David Britt, Patient, Public and Carer Involvement member
  • Mr Cliff Panton, Patient, Public and Carer Involvement member
  • Professor Dame Caroline Watkins, University of Central Lancashire
  • Dr Christopher Sutton, University of Central Lancashire
  • Professor Brenda Roe, Edge Hill University


A UK Collaborative Study funded by the NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC), Health Technology Assessment (HTA) Programme (£1,399,016).


01/11/2017 to 31/01/2021

Further information about the project

ICONS II addresses the management of urinary incontinence (UI) in patients admitted to hospital with acute stroke. UI affects around half of stroke survivors in the acute phase. As many as 44% and 38% of stroke survivors remain incontinent at 3 months and 1 year respectively.

Currently, patients with UI after stroke typically receive care focused on containment using strategies that do not promote continence (e.g. absorbent pads) and are likely to be harmful (e.g. indwelling urethral catheters).

Our intervention, developed and tested in the ICONS feasibility trial, has the potential to reduce the number of patients with UI by at least 5% and improve continence in at least a further 5-10%.

If shown to be effective and adopted across the UK, assuming 40,000 of stroke survivors per annum have UI at 3 months, around 2000 patients would become continent and around 2000-4000 would have improved continence.

The ICONS II trial will provide high quality evidence of the clinical and economic effect of a new paradigm for UI after stroke.

Department of Health disclaimer

The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.


The study is sponsored by the University of Central Lancashire. It is being conducted with Lancashire Clinical Trials Unit, University of Central Lancashire.

Further information

To find out more about ICONS II, please contact the Chief Investigator, Dr Lois Thomas,, 01772 893643, or the Principal Trial Manager, Mrs Denise Forshaw,, 01772 893629.