Prospective, multi-centered, observational.
To characterize the relationship between psychosocial aspects of health-related quality of life (HRQoL) and patient-reported bladder outcomes.
Multi-institutional sites in the United States, cohort drawn from North America.
We performed a cross-sectional analysis of data collected as part of the multicenter, prospective Neurogenic Bladder Research Group Spinal Cord Injury (SCI) Registry. Outcomes were: Neurogenic Bladder Symptom Score (NBSS), Neurogenic Bladder Symptom Score Satisfaction (NBSS-Satisfaction), and SCI-QoL Bladder Management Difficulties (SCI-QoL Difficulties). Adjusted multiple linear regression models were used with variables including demographic, injury characteristics, and the following psychosocial HRQoL measures; SCI-QoL Pain Interference (Pain), SCI-QoL Independence, and SCI-QoL Positive Affect and Well-being (Positive Affect). Psychosocial variables were sub-divided by tertiles for the analysis.
There were 1479 participants, 57% had paraplegia, 60% were men, and 51% managed their bladder with clean intermittent catheterization. On multivariate analysis, higher tertiles of SCI-QoL Pain were associated with worse bladder symptoms, satisfaction, and bladder management difficulties; upper tertile SCI-QoL Pain (NBSS 3.8, p < 0.001; NBSS-satisfaction 0.6, p < 0.001; SCI-QoL Difficulties 2.4, p < 0.001). In contrast, upper tertiles of SCI-QoL Independence and SCI-QoL Positive Affect were associated with improved bladder-related outcomes; upper tertile SCI-QoL Independence (NBSS -2.3, p = 0.03; NBSS-satisfaction -0.4, p < 0.001) and upper tertile SCI-QoL Positive Affect (NBSS -2.8, p < 0.001; NBSS-satisfaction -0.7, p < 0.001; SCI-QoL Difficulties -0.7, p < 0.001).
In individuals with SCI, there is an association between psychosocial HRQoL and bladder-related QoL outcomes. Clinician awareness of this relationship can provide insight into optimizing long-term management after SCI.
Spinal cord. 2021 Jan 25 [Epub ahead of print]
Odinachi Moghalu, John T Stoffel, Sean Elliott, Blayne Welk, Sara Lenherr, Jennifer Herrick, Angela Presson, Jeremy Myers, Neurogenic Bladder Research Group
Department of Surgery (Urology), University of Utah, Salt Lake City, UT, USA. ., Department of Urology, University of Michigan, Ann Arbor, MI, USA., Department of Urology, University of Minnesota, Minneapolis, MN, USA., Department of Urology, Western University, London, ON, Canada., Department of Surgery (Urology), University of Utah, Salt Lake City, UT, USA., Department of Internal Medicine, Division of Epidemiology and Biostatistics, University of Utah, Salt Lake City, UT, USA.