Assessing Patient-Reported Outcomes for Patients with Neurogenic Bladder
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NEUROGENIC BLADDER (C POWELL, SECTION EDITOR)
Assessing Patient-Reported Outcomes for Patients with Neurogenic Bladder Chong Choe & Alvaro Lucioni
Published online: 8 September 2013 # Springer Science+Business Media New York 2013
Abstract Neurogenic bladder is a term applied to a malfunctioning urinary bladder due to a neurologic dysfunction or disease of the central, peripheral, or autonomic nervous system. In a patient with a neurologic disease whose quality of life (QOL) may already be severely affected, urinary incontinence (UI) can result in further reduction of QOL. While no cures are currently available for the most common neurologic diseases, there is much that can be done to improve the QOL of people with neurologic diseases, including those with neurogenic bladder. However, in order to positively impact QOL, it must first be measured. One type of measure for assessing QOL is patient-reported outcomes (PROs). Here we review the current PROs in patients with neurogenic bladder. Assessing PROs in patients with neurogenic bladders is a difficult undertaking since the groups of patients are diversified in their neurogenic conditions and symptoms. Keywords Neurogenic bladder . Urinary incontinence . Quality of life . Stroke . Multiple sclerosis . Parkinson’s disease . Spinal cord injury . Spina bifida
Introduction Normal micturition involves passive low pressure filling of the bladder and a coordinated detrusor contraction coupled with urinary sphincter relaxation for the expulsion of urine. Neurogenic bladder is a term applied to a malfunctioning urinary bladder due to a neurologic dysfunction or disease of the central, peripheral, or autonomic nervous system [1•]. C. Choe : A. Lucioni (*) Section of Urology and Renal Transplantation, Virginia Mason Medical Center, 1100 9th Ave, Seattle, WA 98101, USA e-mail: [email protected] C. Choe e-mail: [email protected]
Urinary incontinence (UI) in patients with neurogenic diseases often occurs due to involuntary bladder contractions. This usually happens during the filling and storage phase of micturition and is referred to as neurogenic detrusor overactivity (NDO) [2••]. Symptoms of NDO can mimic those of overactive bladder (OAB) and can include urinary frequency, urgency, and urge UI. Although clinical presentation varies with the neurologic pathology, the overall goals of management of neurogenic bladder remain the same. The three major objectives include (1) achieving /maintaining continence, (2) preventing upper tract deterioration, (3) and minimizing the risk of symptomatic urinary tract infections [3]. While each of these objectives is important, achieving and maintaining urinary continence plays a major role in improving the patients’ quality of life (QOL). UI has a significant impact on QOL and interferes with daily activities in otherwise healthy people [4]. In a patient with a neurologic disease whose lifestyle and QOL may already be severely affected, UI can result in further reduction of QOL [5, 6]. It is estimated that in the United States n
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