TY - JOUR
T1 - The effects of augmentation cystoplasty and botulinum toxin injection on patient-reported bladder function and quality of life among individuals with spinal cord injury performing clean intermittent catheterization
AU - for the Neurogenic Bladder Research Group (NBRG. org)
AU - Myers, Jeremy B.
AU - Lenherr, Sara M.
AU - Stoffel, John T.
AU - Elliott, Sean P.
AU - Presson, Angela P.
AU - Zhang, Chong
AU - Rosenbluth, Jeffery
AU - Jha, Amitabh
AU - Patel, Darshan P.
AU - Welk, Blayne
N1 - Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2019/1
Y1 - 2019/1
N2 - Aims: Clean intermittent catheterization (CIC) is recommended after spinal cord injury (SCI) because it has the least complications, however, CIC has a high discontinuation rate. We hypothesized that bladder botulinum toxin injection or augmentation cystoplasty may improve satisfaction with CIC. Methods: The NBRG registry is a multicenter, prospective, observational study asking SCI participants about neurogenic bladder (NGB) related quality of life (QoL). In this study, participants performing CIC as primary bladder management were categorized into 3 groups: (1) CIC alone (CIC); (2) CIC with botulinum toxin (CIC-BTX); and (3) CIC with augmentation cystoplasty (CIC-AUG). Outcomes included primary: Neurogenic Bladder Symptom Score (NBSS) and SCI-QoL Bladder Management Difficulties, and secondary: NBSS subdomains (Incontinence, Storage & Voiding, Consequences) and the NBSS final question (satisfaction with urinary function). Multivariable regression, controlling for multiple factors was used to establish differences between the three groups. Results: Eight hundred seventy-nine participants performed CIC as primary bladder management and had the following characteristics: mean age 43.4 (±12.9) and years from injury 13.7 (±10.7), tetraplegia in 284 (32%), and 543 (62%) were men. Bladder management was CIC in 593 (67%), CIC-BTX in 161 (19%), and CIC-AUG in 125(15%). Primary outcomes: CIC-AUG had associated improved total NBSS versus CIC(−3.2(−5.2 to −1.2), P = 0.001 and CIC-BTX(−3.9(−6.3 to −1.6), P = 0.001), CIC-AUG also had better SCI-QoL Difficulties scores versus CIC(−4(−5.48 to −2.53, P < 0.001) and CIC-BTX(−4.4(−6.15 to −2.65, P < 0.001). Secondary outcomes: CIC-AUG had associated improved Incontinence and Satisfaction scores versus CIC and CIC-BTX. Conclusions: Compared to patients performing CIC with or without botulinum toxin treatment, those with augmentation cystoplasty had associated better urinary function and satisfaction with their urinary symptoms.
AB - Aims: Clean intermittent catheterization (CIC) is recommended after spinal cord injury (SCI) because it has the least complications, however, CIC has a high discontinuation rate. We hypothesized that bladder botulinum toxin injection or augmentation cystoplasty may improve satisfaction with CIC. Methods: The NBRG registry is a multicenter, prospective, observational study asking SCI participants about neurogenic bladder (NGB) related quality of life (QoL). In this study, participants performing CIC as primary bladder management were categorized into 3 groups: (1) CIC alone (CIC); (2) CIC with botulinum toxin (CIC-BTX); and (3) CIC with augmentation cystoplasty (CIC-AUG). Outcomes included primary: Neurogenic Bladder Symptom Score (NBSS) and SCI-QoL Bladder Management Difficulties, and secondary: NBSS subdomains (Incontinence, Storage & Voiding, Consequences) and the NBSS final question (satisfaction with urinary function). Multivariable regression, controlling for multiple factors was used to establish differences between the three groups. Results: Eight hundred seventy-nine participants performed CIC as primary bladder management and had the following characteristics: mean age 43.4 (±12.9) and years from injury 13.7 (±10.7), tetraplegia in 284 (32%), and 543 (62%) were men. Bladder management was CIC in 593 (67%), CIC-BTX in 161 (19%), and CIC-AUG in 125(15%). Primary outcomes: CIC-AUG had associated improved total NBSS versus CIC(−3.2(−5.2 to −1.2), P = 0.001 and CIC-BTX(−3.9(−6.3 to −1.6), P = 0.001), CIC-AUG also had better SCI-QoL Difficulties scores versus CIC(−4(−5.48 to −2.53, P < 0.001) and CIC-BTX(−4.4(−6.15 to −2.65, P < 0.001). Secondary outcomes: CIC-AUG had associated improved Incontinence and Satisfaction scores versus CIC and CIC-BTX. Conclusions: Compared to patients performing CIC with or without botulinum toxin treatment, those with augmentation cystoplasty had associated better urinary function and satisfaction with their urinary symptoms.
KW - incontinence
KW - neurogenic bladder
KW - patient reported outcomes
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85055688808&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055688808&partnerID=8YFLogxK
U2 - 10.1002/nau.23849
DO - 10.1002/nau.23849
M3 - Article
C2 - 30375055
AN - SCOPUS:85055688808
SN - 0733-2467
VL - 38
SP - 285
EP - 294
JO - Neurourology and Urodynamics
JF - Neurourology and Urodynamics
IS - 1
ER -