Voiding conditions, renal and bowel function in a cohort of adults with spina bifida

Abstract

Aim To map voiding patterns, degree of continence, use of drugs for voiding disorders, kidney function and surgical interventions but also the bowel function in a near‐total regional cohort of adults with spina bifida aged more than or equal to 18 years. Methods All individuals more than or equal to 18 years of age with spina bifida registered at a regional outpatient clinic (n = 219) were invited to participate, of which 196 persons were included. Bladder and bowel function were assessed according to questions used by the Nordic Spinal Cord Injury Registry by structured interviews and questionnaires in combination with review of patient charts including kidney function. Results Twenty percent of the patients voided spontaneously. Fifty‐four percent used clean intermittent catherization (CIC) and of these, 14% had also undergone augmentation of the bladder and/or implantation of an artificial sphincter or sling, 23% had undergone major urological surgery, and 3% had an indwelling catheter. Seventeen percent of patients voiding spontaneously or using CIC reported total continence but as many as 36% reported daily leakage. Anticholinergics was the most common drug, used by 21% in the total cohort. About 13% of the patients had a reduced kidney function but only 1.5% had end stage renal failure. Seventy‐three percent had problems emptying the bowel and 18% experienced fecal leakage weekly or even daily. Conclusion We found a large variation in problems with bladder and bowel function in this adult group of persons with spina bifida. A structured customized program for follow‐up seems necessary to optimize their health status in these areas.

Adults with spina bifida: A cross‐sectional study of health issues and living conditions

“…Bladder and bowel regimes were assessed with NSCIR (Levi & Ertzgaard, 1998), and part of the results are presented in Table 3. More in‐depth results will be presented in a separate article (Ehrén, Lindbo, Gabrielsson, Bendt, & Seiger, 2020 accepted for publication).…”

“…More in-depth results will be presented in a separate article (Ehrén, Lindbo, Gabrielsson, Bendt, & Seiger, 2020 accepted for publication).…”

Cognitive challenges in persons with spina bifida: Bearing on urological dysfunctions?

“…One hundred forty‐one persons had a myelomeningocele and 13 persons had a non‐myelomeningocele lesion of whom 10 persons were diagnosed with a lipomeningocele and 3 persons with SB occulta. As we in our recently published study 7 found persons in the group with non‐myelomeningocele lesions with urologic/bowel problems, we included all persons in the study group in this survey. Neuropsychological tests from Wechsler Adult Intelligence Scale®—Fourth Edition (WAIS‐IV), known to be sensitive for common cognitive problems in the population with SB 3 were used in the examination of a relationship to urological problems 8 .…”

“…6 A more detailed study of the function of the urinary tract and the bowel function in the cohort has also been performed, describing voiding conditions, complications, renal function, urological interventions and bowel function/dysfunction. 7 When analyzing the urological complications, it became apparent that some patients had difficulties to maintain necessary routines for managing voiding and bowel function, which may be related to their cognitive challenges.…”