The Current Epidemiology of Urinary Incontinence and Urinary Tract Infections After Spinal Cord Injury—A Model Systems Spinal Cord Injury Examination (2016–2021)

J. Clin. Med., 2025 · DOI: https://doi.org/10.3390/jcm14051434 · Published: February 21, 2025

Simple Explanation

This study looks at the prevalence of urinary incontinence (UI) and urinary tract infections (UTIs) in people with spinal cord injuries (SCI). It uses data from the National Spinal Cord Injury Database from 2016 to 2021 to understand how often these issues occur and if they lead to hospitalizations. The study found that UI and UTIs are common after SCI. About 40% of people with SCI reported UI, and over 50% had a UTI in the past year. The risk of UI and UTIs varies depending on how people manage their bladder, such as using catheters or volitional voiding. The researchers also found that people who had more UI and UTIs were more likely to be hospitalized, highlighting the importance of preventing these problems to improve quality of life and reduce healthcare costs.

Study Duration

2016-2021

Participants

5106 individuals within 5 years of SCI

Evidence Level

Not specified

Key Findings

1
Approximately 40% reported UI in the past month and over 50% had a UTI requiring antibiotics in the past year.
2
Incontinence was significantly more frequent in those performing clean intermittent catheterization (CIC) (52% overall, 17% daily) compared to indwelling catheters (29% overall) or volitional void (22% overall).
3
UTIs were most common in those using indwelling catheters (79% with at least one UTI) or CIC (70%) compared to diapers/condom catheters (46%) or volitional void (19%).

Research Summary

The study provides a current snapshot of the frequency of urinary incontinence (UI) and urinary tract infections (UTIs) in the spinal cord injury (SCI) population using data from the National Spinal Cord Injury Database (2016–2021). The results indicate that UI and UTIs are common problems after SCI, with differing frequencies based on bladder management methods. Specifically, UI was more frequent in those using clean intermittent catheterization (CIC), while UTIs were more common in those using indwelling catheters. Both increasing UI and UTI occurrences were associated with an increased frequency of hospitalization, highlighting the need for prevention strategies to improve quality of life and decrease hospitalization rates in this population.

Practical Implications

Emphasis on Prevention

The study suggests that a continued emphasis on prevention is needed to potentially increase quality of life and decrease hospitalization.

Urologic Attention

The data underscore the need for urologic attention when urinary incontinence and UTI conditions are present in SCI patients.

Novel Treatments

The findings support the continued need for the development of novel treatments for both UI and UTIs, such as new pharmaceuticals, UTI vaccines, or neuromodulation-type therapies.

Study Limitations

1
The data are self-reported.
2
There is no granular information on whether an individual received therapy for their urinary incontinence.
3
For those with UTIs, there is no specific urine culture data or associated symptoms to ensure that a “true” UTI was present

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