Patient Reported Bladder Related Symptoms and Quality of Life after Spinal Cord Injury with Different Bladder Management Strategies

No AccessJournal of UrologyAdult Urology1 Sep 2019Patient Reported Bladder Related Symptoms and Quality of Life after Spinal Cord Injury with Different Bladder Management StrategiesThis article is commented on by the following:Editorial Comment Jeremy B. Myers, Sara M. Lenherr, John T. Stoffel, Sean P. Elliott, Angela P. Presson, Chong Zhang, Jeffery Rosenbluth, Amitabh Jha, Darshan P. Patel, and Blayne Welk Jeremy B. MyersJeremy B. Myers *Correspondence: Genitourinary Injury and Reconstructive Urology, 30 North 1900 East, Room 3B420, Salt Lake City, Utah 84132 telephone: 801-213-2700; FAX: 801-585-2891; E-mail Address: [email protected] Department of Surgery (Urology), University of Utah, Salt Lake City, Utah , Sara M. LenherrSara M. Lenherr Department of Surgery (Urology), University of Utah, Salt Lake City, Utah , John T. StoffelJohn T. Stoffel Departments of Urology, University of Michigan, Ann Arbor, Michigan , Sean P. ElliottSean P. Elliott University of Minnesota, Minneapolis, Minnesota , Angela P. PressonAngela P. Presson Division of Epidemiology and Biostatistics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah , Chong ZhangChong Zhang Division of Epidemiology and Biostatistics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah , Jeffery RosenbluthJeffery Rosenbluth Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah , Amitabh JhaAmitabh Jha Department of Physical Medicine and Rehabilitation, Salt Lake City Veterans Medical Center, Salt Lake City, Utah , Darshan P. PatelDarshan P. Patel Department of Surgery (Urology), University of Utah, Salt Lake City, Utah , and Blayne WelkBlayne Welk Western University, London, Ontario, Canada for the Neurogenic Bladder Research Group View All Author Informationhttps://doi.org/10.1097/JU.0000000000000270AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Neurogenic bladder significantly impacts individuals after spinal cord injury. We hypothesized that there would be differences in bladder related symptoms and quality of life for 4 common bladder management methods. Materials and Methods: In this prospective observational study we measured neurogenic bladder related quality of life after spinal cord injury. Study eligibility included age 18 years or greater and acquired spinal cord injury. Bladder management was grouped as 1) clean intermittent catheterization, 2) an indwelling catheter, 3) surgery (bladder augmentation, a catheterizable channel or urinary diversion) and 4) voiding (a condom catheter, involuntary leaking or volitional voiding). The primary outcomes were the NBSS (Neurogenic Bladder Symptom Score) and the SCI-QoL Difficulties (Spinal Cord Injury Quality of Life Measurement System Bladder Management Difficulties). Secondary outcomes were the NBSS subdomains and satisfaction with urinary function. Multivariable regression was done to establish differences between the groups, separated by level. Results: Of the 1,479 participants enrolled in the study 843 (57%) had paraplegia and 894 (60%) were men. Median age was 44.9 years (IQR 34.4–54.1) and median time from injury was 11 years (IQR 5.1–22.4). Bladder management was clean intermittent catheterization in 754 cases (51%), an indwelling catheter in 271 (18%), surgery in 195 (13%) and voiding in 259 (18%). In regard to primary outcomes, in cases of paraplegia and tetraplegia an indwelling catheter and surgery were associated with fewer urinary symptoms on the NBSS compared to clean intermittent catheterization while voiding was associated with more symptoms. In paraplegia and tetraplegia cases surgery was associated with fewer bladder management difficulties according to the SCI-QoL Difficulties. In regard to secondary outcomes, surgery was associated with improved satisfaction in individuals with paraplegia or tetraplegia. Conclusions: In individuals with spinal cord injury fewer bladder symptoms were associated with an indwelling catheter and surgery, and worse bladder symptoms were noted in voiding individuals compared to those on clean intermittent catheterization. Satisfaction with the urinary system was improved after surgery compared to clean intermittent catheterization. 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Supported by PCORI (Patient-Centered Outcomes Research Institute) Award CER14092138. All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor's Note: This article is the third of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 623 and 624. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byMoghalu O, Stoffel J, Elliott S, Welk B, Zhang C, Presson A and Myers J (2021) Time-Related Changes in Patient Reported Bladder Symptoms and Satisfaction after Spinal Cord InjuryJournal of Urology, VOL. 207, NO. 2, (392-399), Online publication date: 1-Feb-2022.Crescenze I, Lenherr S, Myers J, Elliott S, Welk B, O'Dell D and Stoffel J (2020) Self-Reported Urological Hospitalizations or Emergency Room Visits in a Contemporary Spinal Cord Injury CohortJournal of Urology, VOL. 205, NO. 2, (477-482), Online publication date: 1-Feb-2021.Rude T, Moghalu O, Stoffel J, Lenherr S, Myers J, Elliott S, Welk B, Herrick J, Presson A and Ginsberg D (2020) The Role of Health Insurance in Patient Reported Satisfaction with Bladder Management in Neurogenic Lower Urinary Tract Dysfunction Due to Spinal Cord InjuryJournal of Urology, VOL. 205, NO. 1, (213-218), Online publication date: 1-Jan-2021.Wein A (2020) Re: Reasons for Cessation of Clean Intermittent Catheterization after Spinal Cord Injury: Results from the Neurogenic Bladder Research Group Spinal Cord Injury RegistryJournal of Urology, VOL. 204, NO. 3, (624-625), Online publication date: 1-Sep-2020.Wein A (2020) Re: Reasons for Cessation of Clean Intermittent Catheterization after Spinal Cord Injury: Results from the Neurogenic Bladder Research Group Spinal Cord Injury RegistryJournal of Urology, VOL. 204, NO. 2, (391-392), Online publication date: 1-Aug-2020.Elliott S (2020) Re: A Cross-Sectional Study of the Catheter Management of Neurogenic Bladder after Traumatic Spinal Cord InjuryJournal of Urology, VOL. 204, NO. 2, (377-377), Online publication date: 1-Aug-2020.Smith J (2019) This Month in Adult UrologyJournal of Urology, VOL. 202, NO. 3, (431-432), Online publication date: 1-Sep-2019.Related articlesJournal of Urology8 Aug 2019Editorial Comment Volume 202Issue 3September 2019Page: 574-584 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.Keywordsurinary bladderneurogenicpatient reported outcome measuresurinary incontinencequality of lifespinal cord injuriesMetricsAuthor Information Jeremy B. Myers Department of Surgery (Urology), University of Utah, Salt Lake City, Utah *Correspondence: Genitourinary Injury and Reconstructive Urology, 30 North 1900 East, Room 3B420, Salt Lake City, Utah 84132 telephone: 801-213-2700; FAX: 801-585-2891; E-mail Address: [email protected] Financial interest and/or other relationship with PCORI. More articles by this author Sara M. Lenherr Department of Surgery (Urology), University of Utah, Salt Lake City, Utah Financial interest and/or other relationship with PCORI. More articles by this author John T. Stoffel Departments of Urology, University of Michigan, Ann Arbor, Michigan Financial interest and/or other relationship with PCORI. More articles by this author Sean P. Elliott University of Minnesota, Minneapolis, Minnesota Financial interest and/or other relationship with PCORI. More articles by this author Angela P. Presson Division of Epidemiology and Biostatistics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah More articles by this author Chong Zhang Division of Epidemiology and Biostatistics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah More articles by this author Jeffery Rosenbluth Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah Financial interest and/or other relationship with PCORI. More articles by this author Amitabh Jha Department of Physical Medicine and Rehabilitation, Salt Lake City Veterans Medical Center, Salt Lake City, Utah Financial interest and/or other relationship with PCORI. More articles by this author Darshan P. Patel Department of Surgery (Urology), University of Utah, Salt Lake City, Utah Financial interest and/or other relationship with PCORI. More articles by this author Blayne Welk Western University, London, Ontario, Canada Financial interest and/or other relationship with PCORI. More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. Supported by PCORI (Patient-Centered Outcomes Research Institute) Award CER14092138. All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor's Note: This article is the third of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 623 and 624. Advertisement PDF downloadLoading ...