title: Bladder and bowel dysfunction affect quality of life. A cross sectional study of 60 patients with aquaporin-4 antibody positive Neuromyelitis Optica spectrum disorder.
abstract: BACKGROUND
  Transverse myelitis (TM) associated with Neuromyelitis Optica (NMO) can be severe and is well known to reduce mobility early in the disease. However the burden of bladder and bowel dysfunction is unknown and overlooked. We studied the frequency of bladder and bowel dysfunction and their impact on quality of life.
  
  
  METHODS
  A cross-sectional study of 60 patients who had AQP4-IgG positive NMO associated TM was performed using the Bladder Control Scale, Lower Urinary Tract Quality of Life, Bowel Control Scale and Neurogenic Bowel Score, Short-Form-36 Health Survey and EDSS. The relationships between the variables were analysed with multiple linear regression.
  
  
  RESULTS
  Fifty women and 10 men participated. 78% (47/60) patients reported bladder symptoms and a similar number reported bowel problems. 87% (52/60) patients reported either bladder or bowel dysfunction. 65% (39/60) developed residual symptoms after the first episode of myelitis and the remaining by the second episode. Both bladder and bowel dysfunction reduced quality of life and required modification of lifestyle in 83% (39/47) and 70% (33/47) respectively.
  
  
  CONCLUSIONS
  Bladder and bowel dysfunction is very common in NMO associated myelitis developing early in the disease and significantly affects quality of life.
authors.affiliation: Walton Centre Foundation Trust, Liverpool, UK. Electronic address: kerry.mutch@thewaltoncentre.nhs.uk.
authors.forename: Kerry
authors.initials: K
authors.lastname: Mutch
authors.affiliation: Walton Centre Foundation Trust, Liverpool, UK. Electronic address: s.zhao8@liv.ac.uk.
authors.forename: Sizheng
authors.initials: S
authors.lastname: Zhao
authors.affiliation: The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, Queen Square, London, UK. Electronic address: shahd.hamid@thewaltoncentre.nhs.uk.
authors.forename: Shahd
authors.initials: S
authors.lastname: Hamid
authors.affiliation: Walton Centre Foundation Trust, Liverpool, UK. Electronic address: abigail.methley@postgrad.manchester.ac.uk.
authors.forename: Abigail
authors.initials: A
authors.lastname: Methley
authors.affiliation: Walton Centre Foundation Trust, Liverpool, UK. Electronic address: liene.elsone@nhs.net.
authors.forename: Liene
authors.initials: L
authors.lastname: Elsone
authors.affiliation: Walton Centre Foundation Trust, Liverpool, UK. Electronic address: gurpreet.singh@nhs.net.
authors.forename: Gurpreet
authors.initials: G
authors.lastname: Singh
authors.affiliation: Walton Centre Foundation Trust, Liverpool, UK. Electronic address: carolyn.young@thewaltoncentre.nhs.uk.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Young
authors.affiliation: The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, Queen Square, London, UK. Electronic address: a.emmanuel@ucl.ac.uk.
authors.forename: Anton
authors.initials: A
authors.lastname: Emmanuel
authors.affiliation: The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, Queen Square, London, UK. Electronic address: panicker@ucl.ac.uk.
authors.forename: Jalesh
authors.initials: J
authors.lastname: Panicker
authors.affiliation: Walton Centre Foundation Trust, Liverpool, UK. Electronic address: anu.jacob@thewaltoncentre.nhs.uk.
authors.forename: Anu
authors.initials: A
authors.lastname: Jacob
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D055496:Neurogenic Bowel / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D009471:Neuromyelitis Optica / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D006113:United Kingdom / Q000453:epidemiology; D001745:Urinary Bladder Diseases / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D014555:Urination Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D007074:Immunoglobulin G
keywords: Bladder; Bowel; Myelitis; Neuromyelitis Optica; Quality of life