PD46-04 TIME-RELATED CHANGES IN PATIENT-REPORTED BLADDER SYMPTOMS AND SATISFACTION AFTER SPINAL CORD INJURY

Abstract

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making IV (PD46)1 Sep 2021PD46-04 TIME-RELATED CHANGES IN PATIENT-REPORTED BLADDER SYMPTOMS AND SATISFACTION AFTER SPINAL CORD INJURY Odinachi Moghalu, John Stoffel, Sean Elliott, Blayne Welk, Sara Lenherr, Chong Zhang, Angela Presson, and Jeremy Myers Odinachi MoghaluOdinachi Moghalu More articles by this author , John StoffelJohn Stoffel More articles by this author , Sean ElliottSean Elliott More articles by this author , Blayne WelkBlayne Welk More articles by this author , Sara LenherrSara Lenherr More articles by this author , Chong ZhangChong Zhang More articles by this author , Angela PressonAngela Presson More articles by this author , and Jeremy MyersJeremy Myers More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002060.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Neurogenic lower urinary tract dysfunction is a significant source of concern and morbidity to individuals with spinal cord injury (SCI). Increased time from initial SCI is associated with improvements in bladder symptoms and satisfaction, despite a migration to bladder management strategies with higher morbidity such as indwelling catheters (IDC). We sought to better characterize the relationship between time from injury, bladder symptoms and satisfaction. METHODS: This is a cross-sectional analysis of time-related changes in patient reported bladder symptoms and satisfaction using data from the Neurogenic Bladder Research Group Spinal Cord Injury Registry. Study outcomes included: Neurogenic Bladder Symptom Score (NBSS-total) and its overall quality of life (QoL) question (NBSS-Satisfaction). Multivariable regression was performed to assess associations between time from injury and outcomes, adjusting for: demographics, injury characteristics, bladder management, and psychosocial aspects of health related QoL. Time from injury was categorized as 1-5 (ref.), 6-10, 11-15, 16-20, and >20 yrs. RESULTS: Of 1420 participants, median age at injury was 25.9 yrs. (IQR 19.7–38.8) and median time from injury was 11.6 yrs. (IQR 5.7–22.9). Primary bladder management changed with time from injury. There was a decline in use of clean intermittent catheterization (CIC) (55% 1-5 yrs. vs. 45% >20 yrs., p<0.001), and voiding (21% 1-5 yrs. vs. 17% >20 yrs., p<0.001) with increasing time from injury. Meanwhile, management with IDC (16% 1-5 yrs. vs. 21% >20 yrs.) and surgery (8% 1-5 yrs. vs 18% >20 yrs.) increased as time from injury increased (Figure 1). On multivariable analysis, increased time from injury was associated with less bladder symptoms (lower scores) at >20 yrs. from injury (NBSS-total -3.33, p<0.001) and better satisfaction in participants >10 yrs. from injury (NBSS-satisfaction 11-15 yrs. -0.36, 16-20 yrs. -0.59, >20 yrs. -0.86, p<0.001). CONCLUSIONS: Even in a contemporary population of SCI patients, there is a migration away from CIC, and an increase in IDC usage with time from injury. Despite this, there is a significant decrease in urinary symptoms, and improved QoL, even after adjusting for demographics, injury characteristics, bladder management, and psychosocial aspects of health related QoL. Source of 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) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e749-e750 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Odinachi Moghalu More articles by this author John Stoffel More articles by this author Sean Elliott More articles by this author Blayne Welk More articles by this author Sara Lenherr More articles by this author Chong Zhang More articles by this author Angela Presson More articles by this author Jeremy Myers More articles by this author Expand All Advertisement Loading ...