Urinary Symptoms Among People With Neurogenic Lower Urinary Tract Dysfunction (NLUTD) Vary by Bladder Management

Top Spinal Cord Inj Rehabil, 2023 · DOI: 10.46292/sci22-00065 · Published: July 1, 2023

Spinal Cord Injury Urology Patient Experience

Simple Explanation

This study focuses on understanding urinary symptoms in individuals with neurogenic lower urinary tract dysfunction (NLUTD) who manage their bladders differently (indwelling catheter, intermittent catheter, or voiding). The researchers developed and tested questionnaires specific to each bladder management method to see if urinary symptoms should be assessed differently based on how people manage their bladder function. The study found that some urinary symptoms are common regardless of bladder management, while others are specific to the method used, suggesting that assessment should be tailored accordingly.

Study Duration

Not specified

Participants

National samples of people with NLUTD: 336 IC users with SCI, 179 IC users with SB, 66 IC user caregivers; 306 IDC users with SCI, 8 IDC users with MS; 103 voiders with SCI, 405 voiders with MS

Evidence Level

Not specified

Key Findings

1
Ten urinary symptoms are independent of bladder management, forming a 'core' set of NLUTD urinary symptoms.
2
Nine (IDC), 11 (IC), and 8 (V) items are unique to their respective bladder management instruments.
3
Assessment of urinary symptoms for persons with NLUTD should be specific to bladder management method.

Research Summary

The study aimed to determine if assessment of urinary symptoms in people with neurogenic lower urinary tract dysfunction (NLUTD) should depend on bladder management method (indwelling catheter (IDC), intermittent catheter (IC), or voiding (V)). Three surveys (USQNBs) were designed specific to each bladder management method, and subject matter experts qualitatively assessed the wording of validated items to identify potential duplicates, which were then analyzed using unsupervised structural learning. The conclusion was that ten urinary symptoms in NLUTD are independent of bladder management, whereas a similar number depend on bladder management, supporting the need for bladder management-specific assessment.

Practical Implications

Tailored Assessment

Urinary symptom assessment in NLUTD patients should be specific to their bladder management method.

Unified Approach

Despite the need for specific instruments, a single method can summarize symptoms for clinical decisions.

Improved UTI Management

The USQNB instruments facilitate better characterization of urinary symptoms, potentially reducing unnecessary antimicrobial use.

Study Limitations

1
Respondents were self-selected and all US-based.
2
Prioritizing the patient perspective can adversely affect the psychometric functioning of an instrument.
3
Data on these instruments in persons younger than 18 was not collected.

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