Bladder-emptying methods, neurogenic lower urinary tract dysfunction and impact on quality of life in people with long-term spinal cord injury

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1179/2045772315Y.0000000056 · Published: January 1, 2017

Spinal Cord Injury Urology Participation

Simple Explanation

Spinal cord injuries can disrupt communication pathways, leading to neurogenic lower urinary tract dysfunction (NLUTD), causing issues like bladder overactivity or impaired compliance. NLUTD can lead to incontinence and bladder-emptying difficulties, increasing the risk of urinary tract infections (UTIs) and kidney problems. The study aimed to identify the most common bladder-emptying methods used by individuals with long-term SCI and assess the relationship between these methods and their impact on quality of life.

Study Duration

Not specified

Participants

282 wheelchair-dependent persons with SCI for ≥10 years

Evidence Level

Cross-sectional multicenter study

Key Findings

1
Clean intermittent catheterization (CIC) was the most commonly used bladder-emptying method among participants.
2
Transurethral catheter users reported the highest impact of NLUTD on quality of life.
3
Higher age and indwelling catheter use were associated with a greater negative impact of NLUTD on quality of life.

Research Summary

This cross-sectional study investigated bladder-emptying methods and their impact on the quality of life (QoL) of 282 Dutch individuals with long-term spinal cord injuries (SCI). The study found that clean intermittent catheterization (CIC) was the most common method. However, individuals using transurethral catheters reported the lowest QoL. The research highlights the need for clinicians to consider the impact of neurogenic lower urinary tract dysfunction (NLUTD) on QoL when selecting bladder management strategies for people with long-term SCI.

Practical Implications

Optimize Bladder Management

Healthcare providers should focus on optimizing bladder management strategies throughout the lifespan of individuals with SCI to minimize the impact of NLUTD on their quality of life.

Consider Continent Urinary Diversions

Clinicians should consider continent urinary diversions as a valuable alternative for selected patients, especially women and those with paraplegia who have difficulty performing CIC.

Tailor Treatment Plans

Bladder-emptying method selection should be individualized, considering lesion level, manual abilities, convenience, and potential complications.

Study Limitations

1
The study's cross-sectional design limits the ability to analyze associations with time since injury (TSI) and may introduce bias.
2
The study sample predominantly consisted of participants with a traumatic and complete SCI who had acquired their SCI at a relatively young age.
3
The multiple regression model only explained 18% of the variance of the total SF-Qualiveen score.

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