Quality of life and continence in patients with spina bifida.
OBJECTIVE
Spina bifida (SB) is the most common congenital cause of incontinence in childhood. This study attempts to determine the relationships between urinary/faecal incontinence, methods of management, and Health Related Quality of Life (HRQoL) in people with SB.


METHODS
A total of 460 patients (300 adults and 160 adolescents) from six centres in France have taken part in this cross-sectional study. Clinical outcome measures included walking ability, urinary/faecal continence, and medical management. HRQoL was assessed using the SF36 in adults and the VSP in adolescents and their parents. Univariate and multivariate analysis was used to determine the relationships between clinical parameters and HRQoL.


RESULTS
HRQoL were significantly lower than in the general population. Adult women had significantly lower scores than men, and adolescent females had significantly lower scores for psychological well being. We did not found strong relationship between incontinence and HRQoL in this population. Moreover patients surgically managed for urinary/fecal incontinence did not show significantly higher scores of HRQoL.


CONCLUSIONS
Using generic HRQoL measures, urinary/faecal incontinence and their medical management may not play a determinant role in HRQoL of persons with SB. However many other factors affect HRQoL in these patients. A longitudinal study design is recommended to assess whether incontinence management is associated with improved HRQoL.
Lemelle
J L
JL
Service de Chirurgie Infantile, Hôpital d'Enfants, CHU de Nancy, Vandoeuvre les Nancy, France. jl.lemelle@chu-nancy.fr
Guillemin
F
F
Aubert
D
D
Guys
J M
JM
Lottmann
H
H
Lortat-Jacob
S
S
Mouriquand
P
P
Ruffion
A
A
Moscovici
J
J
Schmitt
M
M
D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence; D005260:Female; D005602:France; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016135:Spinal Dysraphism / Q000145:classification / Q000503:physiopathology / Q000523:psychology*; D014549:Urinary Incontinence; D016138:Walking