Presentation Authors: Paholo Barboglio Romo*, Iryna Crescenze, Ann Arbor, MI, Sara Lenherr, Jeremy Myers, Salt Lake City, UT, Blayne Welk, London, Canada, Sean Elliott, Minneapolis, MN, Diana O'Dell, Ann Arbor, MI, Angela Presson, Salt Lake City, UT, John Stoffel, Ann Arbor, MI
Introduction: Bowel dysfunction and severe bowel symptoms are common in Spinal Cord Injured (SCI) patients. The aim of this study was to investigate predictors for severe bowel symptoms in SCI patients and whether type of neurogenic bladder management plan was associated with more severe bowel symptoms.
Methods: The Neurogenic Bladder Research Group (NBRG) registry is a multicenter, prospective, observational study, which measures neurogenic bladder (NGB) related quality of life (QOL) after SCI. Eligibility included: age â‰¥18 years and acquired SCI. Over 1.5 years, 1479 eligible participants were enrolled. Univariate analysis and mixed binomial logistic regression analysis was used evaluate associations between QoL and demographic variables. Bowel symptoms were assessed by Neurogenic Bowel Dysfunction score and patients scoring > 14 were categorized as having severe bowel symptoms. Bladder management was categorized as: voiding, clean intermittent catheterization (CIC), surgery (augmentation/diversion) or indwelling catheter.
Results: Baseline demographics are displayed in Table 1. There were 585 (40%) individuals with severe symptoms and 894 with non-severe. SCI patients performing CIC had the highest percentage of people reporting severe bowel symptoms (48%) followed by indwelling (25%), surgery (16%), and voiding (12%) (p < 0.001). Other variables associated with severe bowel symptoms were high (>T6) level of injury (p=0.005), incomplete injury (p=0.025) and autonomic dysreflexia (p=0.048). The presence of colostomy (p < 0.001) and SF-12 (physical) questionnaire (p=0.037) were protective. All these were modeled into mixed binomial logistic regression analysis and only AD (p < 0.001) and type of management were significantly associated with more severe symptoms. The odds risk (OR) for CIC was 0.74 (95%CI:0.56-0.97), surgery OR 0.52 (95%CI:0.38-0.71), Indwelling OR 0.39 (95%CI:0.29-0.52) when compared to voiding.
Conclusions: Severe bowel symptoms are significantly associated to the management type of neurogenic bladder and the presence of AD. Patients with indwelling catheter and those who underwent surgery had lower risk of severe bowel symptoms. Urologist should assess both bladder and bowel symptoms when counseling on type of management for neurogenic bladder.