title: Quality of life and urological morbidity in tetraplegics with artificial ventilation managed with suprapubic or intermittent catheterisation.
abstract: METHODS
  Mono-centric, retrospective study.
  
  
  OBJECTIVE
  Analysis of correlation between bladder management and age in respirator-dependant high-tetraplegic patients. Additionally suprapubic catheter (SPC) and intermittent catheterisation (IC) were reviewed concerning urological complications and quality of life (QoL).
  
  
  METHODS
  Level 1 trauma centre.
  
  
  METHODS
  A QoL questionnaire 'International Consultation on Incontinence' (ICIQ-SF) was sent to 56 tetraplegic respirator device-dependant (RDD)-spinal cord injury (SCI) patients. Their scores concerning urological morbidity were reviewed. For analysis reasons they were divided in three groups: SPC, IC and others.
  
  
  RESULTS
  SPC 38, IC 12 and others 6 patients. Significant difference in age (SPC vs IC=49.9 vs 31.8 years) was observed but no disparity in gender. Within a follow-up period 2-26 years (median 8 years) significant urological complications in patients with IC (P<0.05) were ascertained. These were in general minor complications. Especially renal deterioration or bladder cancer was not diagnosed in any of the group. The questionnaire return rate was high (83.9%) with complete answers (SPC=32, IC=11). Self assessment of QoL with ICIQ-SF revealed no significant difference for both groups on low level, but SPC patients tend to score better.
  
  
  CONCLUSIONS
  In our study, tetraplegic RDD-SCI patients with SPC suffered less urological complications and tend to score a better QoL. Therefore we recommend SPC as a serious alternative for these selected patients and concurrently underline the necessity of close urological surveillance at least annually.
authors.affiliation: Department Neuro-Urology, BG Trauma Hospital Hamburg, Hamburg, Germany. r.boethig@buk-hamburg.de
authors.forename: R
authors.initials: R
authors.lastname: Böthig
authors.forename: S
authors.initials: S
authors.lastname: Hirschfeld
authors.forename: R
authors.initials: R
authors.lastname: Thietje
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011782:Quadriplegia / Q000150:complications / Q000453:epidemiology*; D011788:Quality of Life; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D011795:Surveys and Questionnaires; D001743:Urinary Bladder / Q000502:physiology; D014546:Urinary Catheterization; D014570:Urologic Diseases / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult