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- Title
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.
- Authors
Myers, Jeremy B.; Lenherr, Sara M.; Stoffel, John T.; Elliott, Sean P.; Presson, Angela P.; Zhang, Chong; Rosenbluth, Jeffery; Jha, Amitabh; Patel, DarshanP; Welk, Blayne
- 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.
- Publication
Neurourology & Urodynamics, 2019, Vol 38, Issue 1, p285
- ISSN
0733-2467
- Publication type
Article
- DOI
10.1002/nau.23849