Satisfaction with bladder management in community-dwelling patients with chronic spinal cord injury

J Formos Med Assoc. 2024 Nov 23:S0929-6646(24)00549-7. doi: 10.1016/j.jfma.2024.11.012. Online ahead of print.

Abstract

Background/purpose: This study aimed to assess the satisfaction of community-dwelling patients with chronic spinal cord injury (SCI) regarding bladder management and urological treatments.

Methods: A survey was conducted among patients with chronic SCI undergoing community health examinations in Taiwan. A total of 1275 patients with chronic SCI were surveyed to collect data on their initial bladder management, urological treatments, changes in bladder management, and satisfaction with current bladder management. The advantages and disadvantages of their current bladder management were retrospectively recorded and analyzed.

Results: The study population included 995 males (78.0%) and 280 females (22.0%) with SCI. The mean age was 32.9 ± 14.9 years (range, 1-89) and the mean duration of SCI was 19.5 ± 12.4 years (range, 1-74). Initial bladder management methods included suprapubic cystostomy, indwelling urethral catheter, or clean intermittent catheterization in 884 patients (69.3%). During follow-up, 414 patients (32.5%) maintained their initial bladder management, while 861 (67.5%) underwent urological treatment or changed their bladder management. Overall, 921 patients (72.2%) reported benefits from changing their initial bladder management or interventions. However, the satisfaction rate with current bladder management was only 40%. After urological treatments, 48.2% of patients were not satisfied but found it acceptable, and 10.7% wished to change their current bladder management.

Conclusion: The bladder management of patients with chronic SCI changed over a 20-year disease duration following urological treatment or minimally invasive procedures. Despite the reported benefits of these interventions, patient satisfaction with the current bladder management remained low.

Keywords: Bladder management; Lower urinary tract dysfunction; Spinal cord injury; Urological treatment.