Quality of life related to urinary continence in adult spina bifida patients.
BACKGROUND
To analyze the correlations of bladder management technique, ambulatory status and urologic reconstruction on quality of life (QOL) as affected by urinary symptoms in adult spina bifida (SB) patients.


METHODS
Sixty-six adult SB patients completed the RAND 36-Item Health Survey (mSF-36) and Incontinence Quality of Life (I-QOL). Demographic information, history of urinary reconstruction, and bladder management techniques were reviewed and analyzed with respect to survey scores.


RESULTS
Mean age of patients was 32.3 (SD ±7.2) years and 44 patients (66.7%) were female. Forty-five patients (68.2%) were mainly ambulatory, 21 (31.8%) use a wheelchair and 10 (15.2%) had urologic reconstruction, while 56 (83.3%) did not. Twelve patients (18.2%) void, 42 (63.6%) perform clean intermittent catheterization (CIC), 4 (6.1%) use an indwelling catheter, 3 (4.5%) have an ileal conduit (IC) and 5 (7.6%) mainly use diapers. Mean mSF-36 General Health score was 56.5 (SD ±22.9) and mean I-QOL Sum score was 50.9 (SD ±21.7), where lower scores reflect lower QOL. mSF-36 and I-QOL scores did not significantly correlate with bladder management technique, ambulatory status or urologic reconstruction. A correlation was noted between I-QOL scales and most mSF-36 scales (all p <0.02).


CONCLUSIONS
In our cohort study of adult SB patients, bladder management technique and urologic reconstruction did not correlate with urinary (I-QOL) or general health (mSF-36) domains, although I-QOL and mSF-36 scores correlated closely, suggesting urinary continence is significantly related to general QOL. However, we are unable to identify a single factor that improves either urinary or general QOL.
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, USA.
Joceline S
JS
Liu
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, USA.
Caroline
C
Dong
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, USA.
Jessica T
JT
Casey
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, USA.
Alyssa
A
Greiman
Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, USA.
Shubhra
S
Mukherjee
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, USA.
Stephanie J
SJ
Kielb
quality of life; spina bifida; urinary continence