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

for the Neurogenic Bladder Research Group (NBRG. org)

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)285-294
Number of pages10
JournalNeurourology and Urodynamics
Volume38
Issue number1
DOIs
StatePublished - Jan 2019

Bibliographical note

Funding Information:
We would like to acknowledge the efforts of our patient stakeholders: Elizabeth Fetter, Jason Hall, and Kelsey Peterson. We would also like to acknowledge Ashlea Wilkes for her enormous efforts as overall study coordinator. This work was supported through a Patient-Centered Outcomes Research Institute (PCORI) Award (CER14092138). All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI.

Funding Information:
Dr. Elliott reports grants from Patient Centered Outcomes Research Institute, during the conduct of the study; grants from Department of Defense, grants from Urotronic, outside the submitted work. Dr. Rosenbluth reports grants from Patient Centered Outcomes Research Institute, during the conduct of the study. Dr. Lenherr reports grants from Patient Centered Outcomes Research Institute, during the conduct of the study; grants from Department of Defense, outside the submitted work. Dr. Myers reports grants from Patient Centered Outcomes Research Institute, during the conduct of the study; grants from Department of Defense, Consulting for Urotronic, Grants from the American Association of Urology, grants from Boston Scientific, outside the submitted work; Angela Presson reports grants from Patient Centered Outcomes Research Institute, during the conduct of the study; Dr. Stoffel reports grants from Patient Centered Outcomes Research Institute, during the conduct of the study; grants from Department of Defense, outside the submitted work. Chong Zhang reports grants from Patient Centered Outcomes Research Institute, during the conduct of the study; grants from Patient Centered Outcomes Research Institute, outside the submitted work.

Keywords

  • incontinence
  • neurogenic bladder
  • patient reported outcomes
  • surgery

Fingerprint Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this