Long-term Bladder and Bowel Management After Spinal Cord Injury: a 20-year Longitudinal Study

Overview

Journal Spinal Cord

Specialty Neurology

Date 2018 Feb 18

PMID 29453362

Citations 8

Authors

Gordana Savic

Hans L Frankel

Mohamed Ali Jamous

Bakulesh M Soni

Susan Charlifue

Affiliations

Soon will be listed here.

Abstract

Study Design: Prospective observational.

Aim: The aim of this study was to analyse changes in bladder and bowel management methods in persons with long-standing spinal cord injury (SCI).

Setting: Two spinal centres in UK.

Method: Data were collected through interviews and examinations between 1990 and 2010 in a sample of persons injured more than 20 years prior to 1990.

Results: For the 85 participants who completed the 2010 follow-up, the mean age was 67.7 years and the mean duration of injury was 46.3 years, 80% were male, 37.7% had tetraplegia AIS grade A, B, or C, 44.7% paraplegia AIS A, B, or C, and 17.6% an AIS D grade regardless of level. In all, 50.6% reported having changed their bladder method, 63.1% their bowel method, and 40.5% both methods since they enroled in the study. The reasons for change were a combination of medical and practical. In men, condom drainage remained the most frequent bladder method, and in women, suprapubic catheter replaced straining/expressing as the most frequent method. The use of condom drainage and straining/expressing bladder methods decreased, whereas the use of suprapubic and intermittent catheters increased. Manual evacuation remained the most frequent bowel management method. The percentage of participants on spontaneous/voluntary bowel emptying, straining and medications alone decreased, whereas the use of colostomy and transanal irrigation increased over time.

Conclusions: More than half the sample, all living with SCI for more than 40 years, required change in their bladder and bowel management methods, for either medical or practical reasons. Regular follow-ups ensure adequate change of method if/when needed.

Citing Articles

Safety of ultrasound-guided percutaneous suprapubic catheter insertion in spinal cord injury patients.

Tiburtius C, Fiebag K, Kowald B, Balzer O, Hirschfeld-Araujo S, Thietje R Spinal Cord Ser Cases. 2024; 10(1):42.

PMID: 38866780 PMC: 11169511. DOI: 10.1038/s41394-024-00653-2.

Priorities, needs and willingness of use of nerve stimulation devices for bladder and bowel function in people with spinal cord injury (SCI): an Australian survey.

Bochkezanian V, Henricksen K, Lineburg B, Myers-Macdonnell L, Bourbeau D, Anderson K Spinal Cord Ser Cases. 2024; 10(1):15.

PMID: 38514608 PMC: 10957911. DOI: 10.1038/s41394-024-00628-3.

Colostomy may offer hope in improving quality of life: a phenomenological qualitative study with patients dependent on a wheelchair.

Kucukakca Celik G, Taylan S Qual Life Res. 2023; 32(7):1981-1989.

PMID: 36869961 DOI: 10.1007/s11136-023-03368-3.

Health Care Utilization and Cost Associated With Urinary Tract Infections in a Privately Insured Spinal Cord Injury Population.

Herrity A, Castillo C, Isakov R, Anele U, Wang D, Boakye M Top Spinal Cord Inj Rehabil. 2023; 29(1):108-117.

PMID: 36819926 PMC: 9936897. DOI: 10.46292/sci22-00022.

Reasons for Altering Bladder Management and Satisfaction with Current Bladder Management in Chronic Spinal Cord Injury Patients.

Yeh H, Kuo H, Tsai C, Lee R Int J Environ Res Public Health. 2022; 19(24).

PMID: 36554912 PMC: 9779055. DOI: 10.3390/ijerph192417032.

References

Faaborg P, Christensen P, Finnerup N, Laurberg S, Krogh K . The pattern of colorectal dysfunction changes with time since spinal cord injury. Spinal Cord. 2007; 46(3):234-8. DOI: 10.1038/sj.sc.3102121. View

Nielsen S, Faaborg P, Finnerup N, Christensen P, Krogh K . Ageing with neurogenic bowel dysfunction. Spinal Cord. 2017; 55(8):769-773. DOI: 10.1038/sc.2017.22. View

Hansen R, Biering-Sorensen F, Kristensen J . Bladder emptying over a period of 10-45 years after a traumatic spinal cord injury. Spinal Cord. 2004; 42(11):631-7. DOI: 10.1038/sj.sc.3101637. View

El-Masri W, Chong T, Kyriakider A, Wang D . Long-term follow-up study of outcomes of bladder management in spinal cord injury patients under the care of the Midlands Centre for Spinal Injuries in Oswestry. Spinal Cord. 2011; 50(1):14-21. DOI: 10.1038/sc.2011.78. View

Christensen P, Bazzocchi G, Coggrave M, Abel R, Hulting C, Krogh K . Outcome of transanal irrigation for bowel dysfunction in patients with spinal cord injury. J Spinal Cord Med. 2008; 31(5):560-7. PMC: 2607129. DOI: 10.1080/10790268.2008.11754571. View

Martinez L, Neshatian L, Khavari R . Neurogenic Bowel Dysfunction in Patients with Neurogenic Bladder. Curr Bladder Dysfunct Rep. 2017; 11(4):334-340. PMC: 5510247. DOI: 10.1007/s11884-016-0390-3. View

Whiteneck G, Charlifue S, Frankel H, Fraser M, Gardner B, Gerhart K . Mortality, morbidity, and psychosocial outcomes of persons spinal cord injured more than 20 years ago. Paraplegia. 1992; 30(9):617-30. DOI: 10.1038/sc.1992.124. View

Adriaansen J, van Asbeck F, Tepper M, Faber W, Visser-Meily J, de Kort L . Bladder-emptying methods, neurogenic lower urinary tract dysfunction and impact on quality of life in people with long-term spinal cord injury. J Spinal Cord Med. 2015; 40(1):43-53. PMC: 5376129. DOI: 10.1179/2045772315Y.0000000056. View

Coggrave M, Ingram R, Gardner B, Norton C . The impact of stoma for bowel management after spinal cord injury. Spinal Cord. 2012; 50(11):848-52. DOI: 10.1038/sc.2012.66. View

10.

Coggrave M, Norton C, Wilson-Barnett J . Management of neurogenic bowel dysfunction in the community after spinal cord injury: a postal survey in the United Kingdom. Spinal Cord. 2008; 47(4):323-30. DOI: 10.1038/sc.2008.137. View

11.

Menter R, Weitzenkamp D, Cooper D, Bingley J, Charlifue S, Whiteneck G . Bowel management outcomes in individuals with long-term spinal cord injuries. Spinal Cord. 1997; 35(9):608-12. DOI: 10.1038/sj.sc.3100461. View

12.

Drake M, Cortina-Borja M, Savic G, Charlifue S, Gardner B . Prospective evaluation of urological effects of aging in chronic spinal cord injury by method of bladder management. Neurourol Urodyn. 2004; 24(2):111-6. DOI: 10.1002/nau.20091. View

13.

Liu C, Huang C, Yang Y, Chen S, Weng M, Huang M . Relationship between neurogenic bowel dysfunction and health-related quality of life in persons with spinal cord injury. J Rehabil Med. 2009; 41(1):35-40. DOI: 10.2340/16501977-0277. View

14.

Christensen P, Bazzocchi G, Coggrave M, Abel R, Hultling C, Krogh K . A randomized, controlled trial of transanal irrigation versus conservative bowel management in spinal cord-injured patients. Gastroenterology. 2006; 131(3):738-47. DOI: 10.1053/j.gastro.2006.06.004. View

15.

Rabadi M, Aston C . Complications and urologic risks of neurogenic bladder in veterans with traumatic spinal cord injury. Spinal Cord. 2014; 53(3):200-203. PMC: 4436035. DOI: 10.1038/sc.2014.205. View

16.

Cameron A, Rodriguez G, Gursky A, He C, Clemens J, Stoffel J . The Severity of Bowel Dysfunction in Patients with Neurogenic Bladder. J Urol. 2015; 194(5):1336-41. DOI: 10.1016/j.juro.2015.04.100. View

17.

Sekar P, Wallace D, Waites K, DeVivo M, Lloyd L, Stover S . Comparison of long-term renal function after spinal cord injury using different urinary management methods. Arch Phys Med Rehabil. 1997; 78(9):992-7. DOI: 10.1016/s0003-9993(97)90063-0. View

18.

Krebs J, Wollner J, Pannek J . Risk factors for symptomatic urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction. Spinal Cord. 2015; 54(9):682-6. DOI: 10.1038/sc.2015.214. View