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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 392-399 |
| Number of pages | 8 |
| Journal | Journal of Urology |
| Volume | 207 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2022 |
Bibliographical note
Funding Information:Funding: This work was partially supported through a Patient-Centered Outcomes Research Institute (PCORI) Award (CER14092138). This investigation was supported by the University of Utah Study Design and Biostatistics Center, with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant 5UL1TR001067-05 (formerly 8UL1TR000105 and UL1RR025764).
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
Keywords
- Health services research
- Neurogenic
- Patient-centered care
- Quality of life
- Urinary bladder
- Spinal Cord Injuries/complications
- Prospective Studies
- Cross-Sectional Studies
- Humans
- Intermittent Urethral Catheterization/adverse effects
- Catheters, Indwelling/adverse effects
- Male
- Self Report/statistics & numerical data
- Urinary Bladder/physiopathology
- Young Adult
- Time Factors
- Patient Satisfaction/statistics & numerical data
- Adolescent
- Quality of Life
- Urinary Bladder, Neurogenic/etiology
- Adult
- Female
- Registries
- Patient Reported Outcome Measures
PubMed: MeSH publication types
- Research Support, Non-U.S. Gov't
- Observational Study
- Journal Article
- Research Support, N.I.H., Extramural