The severity of bowel dysfunction in patients with neurogenic bladder

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Study examined the level of severity and impact on quality of life of bowel dysfunction in people with neurogenic bladder, identified patient variables that correlate with worse bowel symptoms, and investigated whether the severity of bowel dysfunction correlates with the severity of bladder dysfunction. Of the 175 patients evaluated, 60.6 percent had traumatic spinal cord injury (SCI) and 18.3 percent had multiple sclerosis (MS). Median Fecal Incontinence Severity Index (FISI) scores were 18.0 (moderate). The median neurogenic bowel dysfunction score was 11.0 (moderate). Those scores were worse in patients with SCI compared to those with other diseases, younger patients, and those in the SCI group with higher levels of injury. Based on the Bristol stool scale, 65 percent of patients had abnormal stool consistency, mostly constipation. None of the FISI, Bristol, or neurogenic bowel dysfunction scores correlated significantly with quality of life measures. However, bladder symptom scores on the Michigan Incontinence Symptom Index (M-ISI) and American Urological Association symptom index correlated with FISI severity, while the neurogenic bowel dysfunction score correlated with M-ISI. Patients with abnormal stool consistency on the Bristol scale reported more urgency and stress incontinence on M-ISI. The findings suggest that bowel dysfunction is common among patients with neurogenic bladder. Those with worse bladder symptoms also experience worse bowel dysfunction. Bladder symptoms of incontinence and lower urinary tract symptoms correlated directly with bowel symptom scores, signifying how important it is for a treating urologist to address bowel dysfunction along with urinary issues.

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