Quality of Life and the Neurogenic Bladder: Does Bladder Management Technique Matter?

Abstract

People with neurogenic bladder dysfunction often have to make choices about the use of different bladder management techniques to achieve socially acceptable bladder function and to reduce the risk of bladder-related complications. This article reviews the relevant literature on neurogenic bladder related quality of life (QOL) and the impact of different bladder management methods on QOL. There are several neurogenic bladder specific QOL measurement tools available, including the Qualiveen, Incontinence-QOL, SCI-QOL Bladder Management Difficulties/Complications questionnaires, and the Neurogenic Bladder Symptom Score. In general, the use of any type of catheter for bladder management is associated with a reduced QOL among neurogenic bladder patients, and patients who cannot do intermittent catheters independently have a lower QOL compared to patients who can. The literature does not show a consistently better QOL among patients using intermittent catheterization compared to those using indwelling catheters, despite the lower morbidity, and a clear consensus from physicians that it represents the “gold standard” for neurogenic bladder drainage. A greater understanding of the impact of bladder management on QOL is necessary to help counsel and manage patients with neurogenic bladder.