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

Neurogenic Bladder Research Group

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

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 languageEnglish (US)
Pages (from-to)392-399
Number of pages8
JournalJournal of Urology
Volume207
Issue number2
DOIs
StatePublished - Feb 1 2022

Bibliographical note

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

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