MP80-11 ADULT SPINA BIFIDA PATIENTS AND QUALITY OF LIFE RELATED TO URINARY CONTINENCE

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Neurogenic Voiding Dysfunction1 Apr 2014MP80-11 ADULT SPINA BIFIDA PATIENTS AND QUALITY OF LIFE RELATED TO URINARY CONTINENCE Joceline Liu, MD Jessica T. Casey, MS MD Alyssa Greiman, Shubhra Mukherjee, andMD Stephanie KielbMD Joceline LiuJoceline Liu More articles by this author , Jessica T. CaseyJessica T. Casey More articles by this author , Alyssa GreimanAlyssa Greiman More articles by this author , Shubhra MukherjeeShubhra Mukherjee More articles by this author , and Stephanie KielbStephanie Kielb More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2534AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES With improvements in the management and understanding of spina bifida (SB), 75-85% of children with SB are expected to reach early adulthood. Bladder dysfunction is common, with advances in urologic reconstruction and bladder management leading to improved urinary continence. We analyze the correlations of bladder management technique, ambulatory status and urologic reconstruction on quality of life (QOL) as affected by urinary symptoms. METHODS Sixty-five adult SB patients completed the RAND 36-Item Health Survey v2 (SF-36) and Incontinence Quality of Life (I-QOL). Demographic information, history of urinary reconstruction, and bladder management techniques were reviewed and correlated with survey scores. RESULTS The mean age of patients was 32.3 (22-54) years and 44 patients (66.7%) were female. Forty-five patients (68.2%) were mainly ambulatory, 21 (31.8%) use a wheelchair and 10 (15.4%) had urologic reconstruction, while 55 (84.6%) did not. Twelve patients (18.5%) void, 41 (63.1%) perform clean intermittent catheterization (CIC), 4 (6.2%) use an indwelling catheter, 3 (4.6%) have an ileal conduit (IC), and 5 (7.7%) mainly use diapers. Average SF-36 General Health score was 56.5 (SD±22.9) and average I-QOL Sum score was 50.9 (SD±21.7), where lower scores reflect lower QOL. The 8 SF-36 and 3 I-QOL domains were not significantly different with and without urologic reconstruction or based on ambulatory status. No I-QOL scales significantly differed based on bladder management technique; with SF-36 questionnaires, general health rating significantly differed (p=0.027) with highest scores in patients managed with voiding, followed by CIC, IC and diapers, with lowest scores with indwelling catheters. A correlation was noted between I-QOL scales and most SF-36 scales (all p<0.02). CONCLUSIONS Urologic reconstruction and bladder management techniques have evolved in SB patients and affect patients’ daily urinary regimens. In our cohort of adult SB patients, although bladder management technique and urologic reconstruction did not affect scores in the urinary (I-QOL) or general health (SF-36) domains, I-QOL scores correlated with SF-36 scores. Thus, urinary-related QOL is significantly related to overall QOL. However, we are unable to identify a single factor (ambulatory status, reconstruction, management technique, sex, age) that improved either urinary or overall QOL. We need to continue to study the effect of bladder management technique pre- and post-operatively, over time with urologic reconstruction on overall health and urinary QOL in the SB population. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e941-e942 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Joceline Liu More articles by this author Jessica T. Casey More articles by this author Alyssa Greiman More articles by this author Shubhra Mukherjee More articles by this author Stephanie Kielb More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...