title: Guillain-Barré syndrome: prevalence and long-term factors impacting bladder function in an Australian community cohort.
abstract: OBJECTIVE
  Urinary dysfunction is associated with significant morbidity in persons with Guillain-Barré Syndrome (GBS). The aim of this study was to describe prevalence and long-term impact of bladder dysfunction on daily activities and quality of life (QoL) in persons in chronic phase of GBS and to examine the relationships between commonly used continence measures in this cohort.
  
  
  METHODS
  Prospective cohort (n=66) following GBS treatment (1996-2009) was recruited from a tertiary hospital and assessed using standardised measures for bladder dysfunction: American Urological Association (AUA) Symptom Index, Incontinence Impact Questionnaire, Urogenital Distress Inventory.
  
  
  RESULTS
  Sixty-six participants (64% male, mean age 56 years, median disease duration of 6.1 years) completed the study. Of these more than half reported nocturia and one-third reported urinary urgency and frequency. Urinary problems impacted on participants' daily activities: physical recreation (21%), emotional health and mood (17%), entertainment (14%), participation and mobility (>30 min) (12%), and performance of household chores (8%). Since GBS, 49% reported interference of urinary symptoms with daily life to some extent; and adverse impact on QoL (10.6%). Significant relationship between bladder symptoms; and the level of urogenital distress (p<0.001) and the impact of urinary problems (p<0.001), was noted. Higher scores on the bladder scales showed significant correlations with psychological, functional and participation scales. The single QoL item (AUA scale) correlated significantly with all other bladder scales (rho=0.63-0.86). This can be a potential 'screening tool' to identify patients for further assessment.
  
  
  CONCLUSIONS
  Bladder dysfunction in chronic phase of GBS is not well studied. More research in longer-term screening and outcomes for bladder intervention are needed for integrated care and to guide treating clinicians.
authors.affiliation: Department of Rehabilitation Medicine, Royal Melbourne Hospital, Victoria, Australia.
authors.forename: Bhasker
authors.initials: B
authors.lastname: Amatya
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.forename: Michael
authors.initials: M
authors.lastname: Whishaw
authors.forename: Julie F
authors.initials: JF
authors.lastname: Pallant
keywords: Guillain-Barré Syndrome; disability; participation; rehabilitation; urinary tract
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