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Bladder Management and Continence Outcomes in Adults with Spina Bifida: Results from the National Spina Bifida Patient Registry, 2009 to 2015.

Publication ,  Journal Article
Wiener, JS; Suson, KD; Castillo, J; Routh, JC; Tanaka, ST; Liu, T; Ward, EA; Thibadeau, JK; Joseph, DB; National Spina Bifida Patient Registry,
Published in: J Urol
July 2018

PURPOSE: Most children with spina bifida now survive into adulthood, although most have neuropathic bladder with potential complications of incontinence, infection, renal damage and diminished quality of life. In this study we sought to 1) describe contemporary bladder management and continence outcomes of adults with spina bifida, 2) describe differences from younger individuals and 3) assess for association with socioeconomic factors. MATERIALS AND METHODS: We analyzed data on bladder management and outcomes in adults with spina bifida from the National Spina Bifida Patient Registry. A strict definition of continence was used. Results were compared to young children (age 5 to 11 years) and adolescents (12 to 19). Statistical analysis compared cohorts by gender, ethnicity, spina bifida type, lesion level, insurance status, educational attainment, employment status and continence. RESULTS: A total of 5,250 patients with spina bifida were included, of whom 1,372 (26.1%) were adults. Of the adult patients 45.8% did not take medication, but 76.8% performed clean intermittent catheterization. Continence was decreased in adults with myelomeningocele (45.8%) vs those with nonmyelomeningocele spina bifida (63.1%, p <0.0001). Continence rates were higher in the older cohorts with myelomeningocele (p <0.0001) but not in those with nonmyelomeningocele spina bifida (p = 0.1192). Bladder management and history of urological surgery varied among age groups. On univariate analysis with spina bifida related or socioeconomic variables continence was significantly associated with educational level but on multivariable logistic regression analysis bladder continence was significantly associated with employment status only. CONCLUSIONS: Bladder management techniques differ between adults and children with spina bifida. Bladder continence outcomes were better in adults, with nearly half reporting continence. Continence was significantly associated with employment status in patients age 25 years or older.

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Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

July 2018

Volume

200

Issue

1

Start / End Page

187 / 194

Location

United States

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Urinary Incontinence
  • Urinary Bladder, Neurogenic
  • United States
  • Spinal Dysraphism
  • Socioeconomic Factors
  • Self Care
  • Registries
  • Intermittent Urethral Catheterization
 

Citation

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Wiener, J. S., Suson, K. D., Castillo, J., Routh, J. C., Tanaka, S. T., Liu, T., … National Spina Bifida Patient Registry, . (2018). Bladder Management and Continence Outcomes in Adults with Spina Bifida: Results from the National Spina Bifida Patient Registry, 2009 to 2015. J Urol, 200(1), 187–194. https://doi.org/10.1016/j.juro.2018.02.3101
Wiener, John S., Kristina D. Suson, Jonathan Castillo, Jonathan C. Routh, Stacy T. Tanaka, Tiebin Liu, Elisabeth A. Ward, Judy K. Thibadeau, David B. Joseph, and David B. National Spina Bifida Patient Registry. “Bladder Management and Continence Outcomes in Adults with Spina Bifida: Results from the National Spina Bifida Patient Registry, 2009 to 2015.J Urol 200, no. 1 (July 2018): 187–94. https://doi.org/10.1016/j.juro.2018.02.3101.
Wiener JS, Suson KD, Castillo J, Routh JC, Tanaka ST, Liu T, et al. Bladder Management and Continence Outcomes in Adults with Spina Bifida: Results from the National Spina Bifida Patient Registry, 2009 to 2015. J Urol. 2018 Jul;200(1):187–94.
Wiener, John S., et al. “Bladder Management and Continence Outcomes in Adults with Spina Bifida: Results from the National Spina Bifida Patient Registry, 2009 to 2015.J Urol, vol. 200, no. 1, July 2018, pp. 187–94. Pubmed, doi:10.1016/j.juro.2018.02.3101.
Wiener JS, Suson KD, Castillo J, Routh JC, Tanaka ST, Liu T, Ward EA, Thibadeau JK, Joseph DB, National Spina Bifida Patient Registry. Bladder Management and Continence Outcomes in Adults with Spina Bifida: Results from the National Spina Bifida Patient Registry, 2009 to 2015. J Urol. 2018 Jul;200(1):187–194.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

July 2018

Volume

200

Issue

1

Start / End Page

187 / 194

Location

United States

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Urinary Incontinence
  • Urinary Bladder, Neurogenic
  • United States
  • Spinal Dysraphism
  • Socioeconomic Factors
  • Self Care
  • Registries
  • Intermittent Urethral Catheterization