Patient reported outcomes measures in neurogenic bladder and bowel: A systematic review of the current literature

Patel, Darshan P.; Elliott, Sean P.; Stoffel, John T.; Brant, William O.; Hotaling, James M.; Myers, Jeremy B.

doi:10.1002/nau.22673

Cited by 67 publications

(45 citation statements)

References 61 publications

(231 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…All of these were completed in the clinic and included the: MSWS [12, 23] Pain Effects Scale (PES) [24], Bladder and Bowel Control Scales (BLCS and BWCS, respectively) [25], Modified Fatigue Impact Scale, 5-item version (MFIS-5) [26], and the Abbreviated Mental Health Inventory (MHI-5) [27]. …”

Section: Methodsmentioning

confidence: 99%

Continuous daily assessment of multiple sclerosis disability using remote step count monitoring

et al. 2016

View full text Add to dashboard Cite

Disability measures in multiple sclerosis (MS) rely heavily on ambulatory function, and current metrics fail to capture potentially important variability in walking behavior. We sought to determine whether remote step count monitoring using a consumer-friendly accelerometer (Fitbit Flex) can enhance MS disability assessment. 99 adults with relapsing or progressive MS able to walk C2-min were prospectively recruited. At 4 weeks, study retention was 97% and median Fitbit use was 97% of days. Substudy validation resulted in high interclass correlations between Fitbit, ActiGraph and manual step count tally during a 2-minute walk test, and between Fitbit and ActiGraph (ICC = 0.76) during 7-day home monitoring. Over 4 weeks of continuous monitoring, daily steps were lower in progressive versus relapsing MS (mean difference 2546 steps, p \ 0.01). Lower average daily step count was associated with greater disability on the Expanded Disability Status Scale (EDSS) (p \ 0.001). Within each EDSS category, substantial variability in step count was apparent (i.e., EDSS = 6.0 range 1097–7152). Step count demonstrated moderate-strong correlations with other walking measures. Lower average daily step count is associated with greater MS disability and captures important variability in real-world walking activity otherwise masked by standard disability scales, including the EDSS. These results support remote step count monitoring as an exploratory outcome in MS trials.

show abstract

Section: Methodsmentioning

confidence: 99%

Continuous daily assessment of multiple sclerosis disability using remote step count monitoring

et al. 2016

View full text Add to dashboard Cite

show abstract

“…5 Clean intermittent catheterization (CIC), the use of bladder-active medications (BAMs), and close urological follow-up can mitigate many of the potentially life-threatening complications of neurogenic bladder dysfunction, but patients' quality of life (QOL) is considerably affected by the lifelong burden of these interventions, the lack of control of their ability to empty their bladders, and by incontinence and sexual dysfunction. 4,5,9,10,13,15,21,25,[28][29][30] For more than 100 years, researchers and clinicians have pursued a myriad of surgical remedies to allow reinnervation of the urinary bladder, attempting a variety of nerve repair and transfer techniques in experimental animals and in humans. 11 While there has been great success in the clinical use of nerve transfer techniques to reinnervate peripheral nerves of the extremities, 3 there is no surgical nerve transfer or repair procedure that is widely used in patients with neurogenic bladder dysfunction.…”

mentioning

confidence: 99%

Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study

Tuite

Polsky²,

Homsy³

et al. 2016

PED

View full text Add to dashboard Cite

OBJECTIVE Xiao et al. and other investigators have studied an intradural somatic-to-autonomic (e.g., L-5 to S3–4) nerve transfer as a method to create a reflex arc to allow bladder emptying in response to cutaneous stimulation (the Xiao procedure). In previous clinical studies of patients with spinal dysraphism who underwent the Xiao procedure, high success rates (70%–85%) were reported for the establishment of a “skin-CNS-bladder” reflex arc that allows spontaneous, controlled voiding in children with neurogenic bladder dysfunction. However, many of these studies did not use blinded observers, did not have control groups, and/or featured only limited follow-up durations. METHODS A randomized, prospective, double-blind trial was initiated in March 2009, enrolling children with myelomeningocele (MM), lipomyelomeningocele (LMM), and neurogenic bladder dysfunction who were scheduled for spinal cord detethering (DT) for the usual indications. At the time of DT, patients were randomized between 2 arms of the study: half of the patients underwent a standard spinal cord DT procedure alone (DT group) and half underwent DT as well as the Xiao procedure (DT+X group). Patients, families, and study investigators, all of whom were blinded to the surgical details, analyzed the patients' strength, sensory function, mobility, voiding, and urodynamic bladder function before surgery and at regular intervals during the 3-year follow-up. RESULTS Twenty patients were enrolled in the study: 10 underwent only DT and the other 10 underwent DT+X. The addition of the Xiao procedure to spinal cord DT resulted in longer operative times (p = 0.024) and a greater chance of wound infection (p = 0.03). Patients in both treatment arms could intermittently void or dribble small amounts of urine (< 20% total bladder capacity) in response to scratching in dermatomes T-9 through S-2 using a standardized protocol, but the voiding was not reproducible and the volume voided was not clinically useful in any patient. Voiding in response to scratching was not more frequent in patients who underwent DT+X compared with those who underwent only DT. Bladder contractions in response to scratching occurred in both treatment arms at various intervals after surgery, but they were not more reproducible or more frequent in the patients who underwent the Xiao procedure than in the patients who did not. No patient in either treatment arm was continent of urine before, during, or after the study. CONCLUSIONS Patients with MM and LMM who underwent the Xiao procedure during spinal cord DT were no more likely to be able to void, to control their urination, to achieve continence, or to have a demonstrable urodynamic bladder contraction in response to cutaneous stimulation than patients who underwent only spinal cord DT. This study, in the context of disappointing results reported in other recent studies of the Xiao procedure, raises doubts about the clinical applicability of this procedure in humans until further basic science research is performed.

show abstract

“…9,10,15,17,19,20 It has been shown that patients with SCI, multiple sclerosis, Parkinson's disease, stroke, or spina bifida with associated bladder dysfunction have decreased QOL compared with those that do not have bladder dysfunction. 3 We found that patients with suprapubic catheters were more content with their current catheterization method than those with urethral or intermittent catheterization, but there was no correlation between contentment and age, prior history of other catheterization method or level of SCI. There is heterogeneous and sometimes contradictory evidence in the literature regarding whether the bladder management modality impacts QOL in patients with SCI and NGB.…”

Section: Discussionmentioning

confidence: 60%

“…The Veterans Health Administration (VA) is the largest single healthcare system providing comprehensive care for spinal cord injury (SCI) in the nation, currently serving 42 000 veterans with SCI, with 450 new patients enrolling annually . Neurogenic bladder (NGB) occurs in 70‐84% of patients with SCI, causing higher risk for deterioration of renal function as well as decreased quality of life (QOL) . Therefore, appropriate management of NGB is integral to reducing morbidity and improving QOL in patients with SCI.…”

Section: Introductionmentioning

confidence: 99%

A cross‐sectional study of the catheter management of neurogenic bladder after traumatic spinal cord injury

Lane

Driscoll

Tawfik

et al. 2017

Neurourology and Urodynamics

View full text Add to dashboard Cite

Aims: This cross-sectional study describes the catheter management of neurogenic bladder (NGB) in patients with traumatic spinal cord injury (tSCI) with emphasis on the motivations behind transitions between intermittent (IC) and indwelling catheters. Methods: Patients at the Minneapolis VA with history of tSCI who utilized either intermittent catheterization (IC), urethral (UC) or suprapubic (SP) catheters, participated in a voluntary, anonymous survey regarding their bladder management strategies. Results: A total of 100 patients participated, 94% were male and 90% Caucasian with median age of 61 years. Patients with current UC or SP were older than those utilizing IC (P = 0.002). The median age at injury and years since SCI were 32 years and 20.5 years, respectively. The median time with current modality was 11 years. A total of 27% of all patients reported at least one transition between catheter type. A total of 14 of 54 patients using IC had prior use of UC or SP, while 12/25 patients using SP and 10/21 patients using UC had prior use of IC. The most common reasons to stop IC included inconvenience, physician recommendation, and dislike of IC. A total of 53% of patients currently using UC or SP reported never using IC. Patients currently using SP were more content with their current catheterization method than those using UC or IC (P = 0.046). Conclusions: Among patients using catheters for NGB, intermittent catheterization

show abstract

Patient reported outcomes measures in neurogenic bladder and bowel: A systematic review of the current literature

Abstract: Current PRO measures (PROM) and QoL assessments are heterogeneous and several inconsistencies in clinical and PRO for various management options exist. Standardized PROM will help identify optimal bladder and bowel management for patients with neurologic conditions.

Cited by 67 publications

References 61 publications

Continuous daily assessment of multiple sclerosis disability using remote step count monitoring

Continuous daily assessment of multiple sclerosis disability using remote step count monitoring

Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study

A cross‐sectional study of the catheter management of neurogenic bladder after traumatic spinal cord injury

Contact Info

Product

Resources

About