Time-Related Changes in Patient Reported Bladder Symptoms and Satisfaction After Spinal Cord Injury

Overview

Journal J Urol

Publisher Wolters Kluwer

Specialty Urology

Date 2021 Sep 22

PMID 34547924

Citations 3

Authors

Odinachi Moghalu

John T Stoffel

Sean P Elliott

Blayne Welk

Chong Zhang

Angela Presson

Jeremy Myers

Affiliations

Soon will be listed here.

Abstract

Purpose: Increased time after spinal cord injury (SCI) is associated with a migration to bladder managements with higher morbidity such as indwelling catheter (IDC). Still, it is unclear how this affects bladder-related quality of life (QoL). We hypothesized that time from injury (TFI) would be associated with changes in bladder management, symptoms and satisfaction.

Materials And Methods: Cross-sectional analysis of time-related changes in patient-reported bladder management, symptoms and satisfaction using the Neurogenic Bladder Research Group SCI Registry. Outcomes included Neurogenic Bladder Symptom Score (NBSS) and bladder-related satisfaction (NBSS-satisfaction). Multivariable regression was performed to assess associations between TFI and outcomes, adjusting for participant characteristics, injury specifics, and psychosocial aspects of health-related QoL. Participants with TFI <1 year were excluded and TFI was categorized 1-5 (reference), 6-10, 11-15, 16-20 and >20 years.

Results: Of 1,420 participants mean age at injury was 29.7 years (SD 13.4) and mean TFI was 15.2 years (SD 11.6). Participants grouped by TFI included 298 (21%) 1-5, 340 (24%) 6-10, 198 (14%) 11-15, 149 (10%) 16-20 and 435 (31%) >20 years. As TFI increased, clean intermittent catheterization (CIC) declined (55% 1-5 vs 45% >20 years, p <0.001) and IDC increased (16% 1-5 vs 21% >20 years, p <0.001). On multivariable analysis, increased TFI was associated with fewer bladder symptoms at >20 years from injury (-3.21 [CI -1.29, -5.14, p <0.001]) and better satisfaction (6-10 years -0.20 [CI -0.41, 0.01, p=0.070], 11-15 years -0.36 [CI -0.60, -0.11, p=0.002], 16-20 years -0.59 [CI -0.86, -0.32, p <0.001], >20 years -0.85 [CI -1.07, -0.63, <0.001]).

Conclusions: After SCI, CIC decreases and IDC increases over time; however, increasing TFI is associated with reduced urinary symptoms and improved bladder-related satisfaction.

Citing Articles

Impact of urinary catheters including reusable catheters on quality of life and work productivity in persons with spinal cord lesion.

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Cognitive interviewing validation of the Chinese version of the neurogenic bladder symptom score.

Wang X, Gao S, Wang T, Xue J, Yang Y, Han L Heliyon. 2024; 10(18):e37435.

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Rehabilitation care of patients with neurogenic bladder after spinal cord injury: A literature review.

Xiang L, Li H, Xie Q, Siau C, Xie Z, Zhu M World J Clin Cases. 2023; 11(1):57-64.

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References

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

Weld K, Graney M, Dmochowski R . Differences in bladder compliance with time and associations of bladder management with compliance in spinal cord injured patients. J Urol. 2000; 163(4):1228-33. View

Groah S, Weitzenkamp D, Lammertse D, Whiteneck G, Lezotte D, Hamman R . Excess risk of bladder cancer in spinal cord injury: evidence for an association between indwelling catheter use and bladder cancer. Arch Phys Med Rehabil. 2002; 83(3):346-51. DOI: 10.1053/apmr.2002.29653. View

Chen Y, DeVivo M, Roseman J . Current trend and risk factors for kidney stones in persons with spinal cord injury: a longitudinal study. Spinal Cord. 2000; 38(6):346-53. DOI: 10.1038/sj.sc.3101008. View

Simpson L, Eng J, Hsieh J, Wolfe D . The health and life priorities of individuals with spinal cord injury: a systematic review. J Neurotrauma. 2012; 29(8):1548-55. PMC: 3501530. DOI: 10.1089/neu.2011.2226. View

Kennedy P, Rogers B . Reported quality of life of people with spinal cord injuries: a longitudinal analysis of the first 6 months post-discharge. Spinal Cord. 2000; 38(8):498-503. DOI: 10.1038/sj.sc.3101021. View

Abrams P, Agarwal M, Drake M, El-Masri W, Fulford S, Reid S . A proposed guideline for the urological management of patients with spinal cord injury. BJU Int. 2008; 101(8):989-94. DOI: 10.1111/j.1464-410X.2008.07457.x. View

Etingen B, Miskevics S, LaVela S . The Relationship Between Pain Interference and Psychosocial Well-Being Among Veterans With Spinal Cord Injuries/Disorders. J Neurosci Nurs. 2017; 50(1):48-55. DOI: 10.1097/JNN.0000000000000341. View

Welk B, Morrow S, Madarasz W, Baverstock R, Macnab J, Sequeira K . The validity and reliability of the neurogenic bladder symptom score. J Urol. 2014; 192(2):452-7. DOI: 10.1016/j.juro.2014.01.027. View

10.

Lane G, Driscoll A, Tawfik K, Chrouser K . A cross-sectional study of the catheter management of neurogenic bladder after traumatic spinal cord injury. Neurourol Urodyn. 2017; 37(1):360-367. DOI: 10.1002/nau.23306. View

11.

Patel D, Herrick J, Stoffel J, Elliott S, Lenherr S, Presson A . Reasons for cessation of clean intermittent catheterization after spinal cord injury: Results from the Neurogenic Bladder Research Group spinal cord injury registry. Neurourol Urodyn. 2019; 39(1):211-219. DOI: 10.1002/nau.24172. View

12.

Cardenas D, Hoffman J, Kirshblum S, McKinley W . Etiology and incidence of rehospitalization after traumatic spinal cord injury: a multicenter analysis. Arch Phys Med Rehabil. 2004; 85(11):1757-63. DOI: 10.1016/j.apmr.2004.03.016. View

13.

Weld K, Dmochowski R . Effect of bladder management on urological complications in spinal cord injured patients. J Urol. 2000; 163(3):768-72. View

14.

Schwartz C, Stucky B, Rivers C, Noonan V, Finkelstein J . Quality of Life and Adaptation in People With Spinal Cord Injury: Response Shift Effects From 1 to 5 Years Postinjury. Arch Phys Med Rehabil. 2018; 99(8):1599-1608.e1. DOI: 10.1016/j.apmr.2018.01.028. View

15.

Afsar S, Yemisci O, Cosar S, Cetin N . Compliance with clean intermittent catheterization in spinal cord injury patients: a long-term follow-up study. Spinal Cord. 2013; 51(8):645-9. DOI: 10.1038/sc.2013.46. View

16.

Moghalu O, Stoffel J, Elliott S, Welk B, Lenherr S, Herrick J . Psychosocial aspects of health-related quality of life and the association with patient-reported bladder symptoms and satisfaction after spinal cord injury. Spinal Cord. 2021; 59(9):987-996. PMC: 8483561. DOI: 10.1038/s41393-020-00609-x. View

17.

Cetinel B, Onal B, Turegun F, Erdogan S . Urologic health condition of spinal cord-injured patients living in Turkey. Spinal Cord. 2014; 52(4):302-6. DOI: 10.1038/sc.2013.173. View

18.

Myers J, Lenherr S, Stoffel J, Elliott S, Presson A, Zhang C . Patient Reported Bladder Related Symptoms and Quality of Life after Spinal Cord Injury with Different Bladder Management Strategies. J Urol. 2019; 202(3):574-584. DOI: 10.1097/JU.0000000000000270. View

19.

Welk B, Lenherr S, Elliott S, Stoffel J, Presson A, Zhang C . The Neurogenic Bladder Symptom Score (NBSS): a secondary assessment of its validity, reliability among people with a spinal cord injury. Spinal Cord. 2017; 56(3):259-264. DOI: 10.1038/s41393-017-0028-0. View

20.

. Bladder management for adults with spinal cord injury: a clinical practice guideline for health-care providers. J Spinal Cord Med. 2007; 29(5):527-73. PMC: 1949036. View