Long-term bladder and bowel management after spinal cord injury: A 20-year longitudinal study

Model System:

SCI

Reference Type:

Journal article

Accession No.:

J80392

Journal:

Spinal Cord (formerly Paraplegia)

Year, Volume, Issue, Page(s):

2018 , 56, 6, 575-581

Publication Website:

Abstract:

Study analyzed changes in bladder and bowel management methods in adults with long-standing spinal cord injury (SCI). Data were collected through interviews and examinations between 1990 and 2010 in a group of subjects injured more than 20 years prior to 1990. For the 85 participants who completed the 2010 follow-up, the mean age was 67.7 years and the mean duration of injury was 46.3 years. Eighty percent were male, 37.7 percent had tetraplegia American Spinal Injuries Association (ASIA) Impairment Scale (AIS) grade A, B, or C, 44.7 percent paraplegia AIS A, B, or C, and 17.6 percent were AIS D grade regardless of level. In all, 50.6 percent reported having changed their bladder method, 63.1 percent their bowel method, and 40.5 percent both methods since they enrolled in the study. The reasons for change were a combination of medical and practical. In men, condom drainage remained the most frequent bladder method, and in women, suprapubic catheter replaced straining/expressing as the most frequent method. The use of condom drainage and straining/expressing bladder methods decreased, whereas the use of suprapubic and intermittent catheters increased. Manual evacuation remained the most frequent bowel management method. The percentage of participants on spontaneous/voluntary bowel emptying, straining and medications alone decreased, whereas the use of colostomy and transanal irrigation increased over time. Findings indicate that more than half the sample, all living with SCI for more than 40 years, required change in their bladder and bowel management methods, for either medical or practical reasons. Regular follow-ups ensure adequate change of method if/when needed.

Author(s):