Impact of clean intermittent catheterization on quality adjusted life years (QALYs) in spinal cord injury patients with neurogenic urinary incontinence

The impact of clean intermittent catheterization (CIC) on quality adjusted life years (QALYs) gained in adults' spinal cord injury population with neurogenic urinary incontinence (UI).

Patients were recruited from the national registry January-June 2014. The inclusion criteria were adults, neurogenic UI due to spinal cord injury (SCI), use of collection devices and CIC for more than 6 months. The exclusion criteria were inability to perform CIC, cancer of the lower urinary tract and fistulas formation. Measurement tools were the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and an estimation of life expectancy by the national registry. The calculation of the weighting factor (WF) was obtained by linear transformation of the ICIQ-UI SF total score. A score was transformed to the range from 0 (worst impact) to 1 (no impact). The QALYs was calculated as the weighting factor × life expectancy in years.

A total of 229/365 patients were involved in this study (63%). Patients before CIC reached an ICIQ mean score of 14.83, WF of 0.29, and QALYs of 9.02 during life expectancy. After 6 months of follow-up using CIC, ICIQ reached 9.12, WF 0.57 and QALYs 17.45. The number of QALYs increased by 93.5% and UI evaluated with the ICIQ-UI SF decreased by 38.5% (P < 0.01).

The CIC of the urinary bladder statistically significantly increased the number of QALYs and reduced the degree of UI in SCI patients.

Neurourology and urodynamics. 2017 Apr 13 [Epub ahead of print]

Jan Svihra, Jan Krhut, Roman Zachoval, Viera Svihrova, Jan Luptak

Department of Urology, Jessenius Faculty of Medicine, Comenius University Bratislava, Martin, Slovak Republic., Department of Urology, University Hospital, Ostrava, Czech Republic., Department of Urology, Thomayer Hospital and Department of Urology, 1st and 3rd Faculty of Medicine, Charles University, Prague, Czech Republic., Department of Public Health, Jessenius Faculty of Medicine, Comenius University Bratislava, Martin, Slovak Republic.

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