Effects of different bladder management methods on the quality of life in patients with traumatic spinal cord injury

Abstract

Study design: Multi-center, cross-sectional study. Objectives: To investigate the effects of different bladder management methods on the quality of life (QoL) in patients with spinal cord injury (SCI). Setting: Turkey. Methods: Consecutive SCI patients (n ¼ 195, 74.4% males), for whom at least 6 months had elapsed since the injury, were included and evaluated in five groups: normal spontaneous micturition (NSM), micturition with assisted maneuvers (MAM), aseptic intermittent catheterization by patient (IC-P), aseptic IC by an attendant/caregiver (IC-A) and indwelling catheterization. The King's Health Questionnaire was used to evaluate the patients' QoL. Results: The bladder management groups were similar regarding age, time elapsed since injury, education level, marital and occupational status. There was no difference among the groups in general health perception, personal relationships and sleep/energy domain scores. While the NSM group had generally the lowest scores, that is, better QoL, the IC-A group had the highest scores, that is, poorer QoL, in most of the domains. When the patients were grouped according to the frequency of urinary incontinence or American Spinal Injury Association Impairment Scale grades, no difference was found in the domain scores of the groups except the symptom severity domain scores. No significant difference was found between paraplegic and tetraplegic patients in the King's Health Questionnaire domains. Conclusion: The QoL was notably affected in SCI patients in IC-A group and negative effects on emotional status, physical and social activity limitations were observed, as well.

Factors Which Facilitate or Impede Interpersonal Interactions and Relationships after Spinal Cord Injury: A Scoping Review with Suggestions for Rehabilitation

“…The most frequently cited body structure and function factors which impeded interpersonal interactions and relationships pertain to bladder and bowel dysfunction [42, 54, 55, 57, 60, 75, 82, 90]. As well as suffering the actual embarrassment of incontinence (particularly during intimate moments), there was a fear of incontinence which held some back from fully engaging with intimate partners and in other social situations.…”

“…The time-consuming nature of carrying out activities of daily living, dependence on others for personal care, such as bladder management, and the inability to act spontaneously were all cited as impeding socializing, forming relationships, and enjoying sexual intimacy [34, 55, 59, 63, 66, 81, 90]. Independence can positively influence the experience of sexuality [43] and higher levels of mobility can impact couple satisfaction and cohesion [83].…”

Bladder management experiences among people living with neurologic disease: A systematic review and meta‐synthesis of qualitative research

“…Many patients require assistance emptying their bladder, and often this includes the use of urinary catheters. In general, the use of catheters in neurogenic bladder patients results in a worse quality of life (QOL) compared to individuals who can void spontaneous . However, these studies do not identify the exact reasons why QOL is worse, and in some cases psychosocial factors are actually quite similar independent of bladder management strategy .…”

Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction

“…Depending on the type of dysfunction, NLUTD can affect the upper urinary tract with the risk of renal failure, and it can impair the quality of life. 5,6 Therefore, treatment of NLUTD is not based on symptoms alone, but it should focus on the results of urodynamic testing.…”

“…Depending on the type of dysfunction, NLUTD can affect the upper urinary tract with the risk of renal failure, and it can impair the quality of life. 5,6 Therefore, treatment of NLUTD is not based on symptoms alone, but it should focus on the results of urodynamic testing.Sacral neuromodulation (SNM) is a minimally invasive approach for the treatment of LUT dysfunction. The mechanism of action is not completely clarified, but a central modulation of afferent and efferent signals in the spinal cord and the supraspinal areas seems to have a crucial role.…”