Etiology of spinal cord injury affects quality of life after bladder surgery

For patients undergoing urinary diversion for neurogenic bladder (NGB), the postoperative impact on urinary-related quality of life (UrQOL) is milder with a congenital (C-SCI) etiology of spinal cord injury than with an acquired (A-SCI) etiology, according to a study published online July 1st in PM&R.

João Pedro Emrich Accioly, MD, of the Glickman Urological and Kidney Institute at the Cleveland Clinic Foundation, and colleagues compared decision regret and UrQOL in patients undergoing urinary diversion for NGB due to A-SCI (17 patients with traumatic spinal cord injury) and C-SCI (20 patients with spina bifida) etiologies. A-SCI was compared to C-SCI in terms of decision regret, UrQOL, and postoperative changes in self-reported physical health, mental health, and pain.

The researchers found that the A-SCI group had worse preoperative physical health compared with the C-SCI cohort; after adjusting for baseline scores and follow-up time, absolute postoperative changes in this score and in the mental health score and pain level were not significant. After adjusting for other factors, a significantly worse impact of NGB on UrQOL was seen for A-SCI than for C-SCI. No differences in decision regret were observed between the groups.

“We were able to demonstrate that patients with A-SCI report poorer physical health at baseline and lower UrQOL after reconstructive surgery, compared to a demographically and clinically similar C-SCI population,” the authors write.

“These findings may be a valuable addition to discussions between healthcare providers and patients when considering surgical treatment of NGB.”

One author indicated affiliation with Boston Scientific.

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