PD64-04 QUALITY OF LIFE ASSOCIATED WITH BLADDER MANAGEMENT STRATEGY AFTER SPINAL CORD INJURY

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction II1 Apr 2017PD64-04 QUALITY OF LIFE ASSOCIATED WITH BLADDER MANAGEMENT STRATEGY AFTER SPINAL CORD INJURY Shyam Sukumar, Sara Lenherr, Jeremy Myers, Darshan Patel, Ronak Gor, Amitabh Jha, Angela Presson, Chong Zhang, Jeffrey Rosenbluth, John Stoffel, Blayne Welk, and Sean Elliott Shyam SukumarShyam Sukumar More articles by this author , Sara LenherrSara Lenherr More articles by this author , Jeremy MyersJeremy Myers More articles by this author , Darshan PatelDarshan Patel More articles by this author , Ronak GorRonak Gor More articles by this author , Amitabh JhaAmitabh Jha More articles by this author , Angela PressonAngela Presson More articles by this author , Chong ZhangChong Zhang More articles by this author , Jeffrey RosenbluthJeffrey Rosenbluth More articles by this author , John StoffelJohn Stoffel More articles by this author , Blayne WelkBlayne Welk More articles by this author , and Sean ElliottSean Elliott More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2941AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Little is known about the relative quality of life (QoL) benefits of different bladder management strategies after spinal cord injury (SCI). We sought to describe bladder-related symptoms and QoL using a national sample of SCI patients. METHODS Data from a national prospective observational survey was used. Demographic and clinical information were obtained by interview. The Neurogenic Bladder Symptom Score (NBSS), a validated tool to measure urinary symptoms, was administered electronically. Patient demographics, NBSS total score and the NBSS QoL question (“If you had to live the rest of your life with the way your bladder (or urinary reservoir) currently works, how would you feel?”) were compared with bladder management method using chi-squared, Fisher′s exact, ANOVA and Kruskal-Wallis tests as appropriate. RESULTS Since January 2016, 780 participants completed the baseline interview. Median age was 46 (interquartile range, IQR: 35-56) with median 27 (IQR: 20-41) years since injury. 39% of participants were recruited in clinic and 55% online/remote. SCI level was: 49% paraplegia, 43% tetraplegia, and 8% unknown/other. Current bladder management was: 63% clean-intermittent catheterization (CIC), 23% indwelling suprapubic/urethral catheter or stoma, 9% spontaneous voiding, and 5% condom catheter. Those using CIC were significantly younger than those using other bladder management methods (p<0.001) and those using spontaneous voiding had the longest median time since injury (p<0.001). The total NBSS score was lowest for indwelling catheter/stoma (18.3 ± 10.5) as compared to condom catheter (22.9 ± 9.3), CIC (24.5 ± 9.9) and spontaneous voiding (28.1 ± 11.9) (p <0.001). Similarly, bladder QoL was ″pleased″ or ″mostly satisfied″ in 43% of people with an indwelling catheter/stoma, 35% for CIC, 27% for condom catheter, and 26% for spontaneously voiding (chi-square test with permutation, p=0.012; Figure 1). CONCLUSIONS In a large cohort of SCI patients, indwelling catheters or stoma drainage was associated with reduced bladder-related symptoms and consequences and best QoL among bladder management methods. This patient-centered outcome differs from the urologists preference for CIC based on medical benefits. Further exploration is needed to understand the patient-reported QoL and clinical outcomes. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1261 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Shyam Sukumar More articles by this author Sara Lenherr More articles by this author Jeremy Myers More articles by this author Darshan Patel More articles by this author Ronak Gor More articles by this author Amitabh Jha More articles by this author Angela Presson More articles by this author Chong Zhang More articles by this author Jeffrey Rosenbluth More articles by this author John Stoffel More articles by this author Blayne Welk More articles by this author Sean Elliott More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...