PD43-10 THE EFFECTS OF AUGMENTATION CYSTOPLASTY AND BOTULINUM TOXIN INJECTION ON PATIENT-REPORTED BLADDER FUNCTION AND SATISFACTION AMONG SPINAL CORD INJURY PATIENTS PERFORMING INTERMITTENT CATHETERIZATION

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II1 Apr 2018PD43-10 THE EFFECTS OF AUGMENTATION CYSTOPLASTY AND BOTULINUM TOXIN INJECTION ON PATIENT-REPORTED BLADDER FUNCTION AND SATISFACTION AMONG SPINAL CORD INJURY PATIENTS PERFORMING INTERMITTENT CATHETERIZATION Jeremy Myers, Sara Lenherr, John Stoffel, Sean Elliott, Angela Presson, Chong Zhang, and Blayne Welk Jeremy MyersJeremy Myers More articles by this author , Sara LenherrSara Lenherr More articles by this author , John StoffelJohn Stoffel More articles by this author , Sean ElliottSean Elliott More articles by this author , Angela PressonAngela Presson More articles by this author , Chong ZhangChong Zhang More articles by this author , and Blayne WelkBlayne Welk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2122AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Clean intermittent catheterization (CIC) is the bladder management strategy recommended by clinicians after spinal cord injury (SCI) because it has the least complications. However, dissatisfaction with CIC is evident by high rates of switching to other forms of bladder management over time, mostly to indwelling catheters. We hypothesize that interventions such as bladder botulinum toxin injection or augmentation cystoplasty can improve satisfaction with CIC. METHODS The NBRG registry is a multicenter, prospective, observational study asking SCI participants about neurogenic bladder related quality of life. Eligibility included: age >18 years and acquired SCI. Over 1.5 years, 1479 participants enrolled. From this cohort, those performing CIC as primary bladder management were categorized into 3 groups: 1) CIC-alone, 2) CIC using botulinum toxin (CIC-BTX), and 3) CIC with augmentation cystoplasty (CIC-AUG). Multivariate linear regression was used, controlling for multiple factors, to establish differences in the Neurogenic Bladder Symptom Score (NBSS), its sub-domains (Incontinence, Storage & Voiding, and Consequences), and the final question of the NBSS (satisfaction with urinary function) between the 3 groups. The mean, across groups, for each measure was reported as a point of reference for the magnitude of change. A negative change for the NBSS indicates improvement in function / satisfaction. Values were reported with standard deviation and 95% confidence intervals. RESULTS 879 participants identified CIC as their primary bladder management. The mean age was 43.4 (±12.9) and mean years from injury was 13.7 (±10.7). Level of injury was tetraplegia in 284 (32%); 337 (38%) were women. Bladder management was CIC-alone in 593 (67%), CIC-BTX in 161 (19%), and CIC-AUG in 125 (15%). Total NBSS (mean 25±10.1) did not differ between CIC-alone and CIC-BTX but was improved for CIC-AUG (-3.9 (-5.9˜-1.8, p<0.001). Similarly, the Incontinence subdomain (mean 10.4±6.8) did not differ between CIC-alone and CIC-BTX but was improved in CIC-AUG (-2.82(-4.14˜-1.49), p<0.001). There were no differences between groups in the other 2 NBSS subdomains. Satisfaction with urinary function (mean 2.1±1.2) did not differ between CIC-alone and CIC-BTX, but was improved in CIC-AUG (-1.11(-1.43˜-0.8), p<0.001). CONCLUSIONS Individuals performing CIC after SCI had the best urinary function and satisfaction after augmentation cystoplasty. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e880 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jeremy Myers More articles by this author Sara Lenherr More articles by this author John Stoffel More articles by this author Sean Elliott More articles by this author Angela Presson More articles by this author Chong Zhang More articles by this author Blayne Welk More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...