Bladder Management and Continence Outcomes in Adults with Spina Bifida: Results from the National Spina Bifida Patient Registry 2009-15.
Most children with spina bifida (SB) now survive into adulthood, but most have neuropathic bladder with potential complications of incontinence, infection, renal damage, and diminished quality of life. We sought to 1) describe contemporary bladder management and continence outcomes of adults with SB; 2) describe differences from younger patients; and 3) assess for association with socio-economic factors.We analyzed data on bladder management and outcomes from The National Spina Bifida Patient Registry in adults with SB. A strict definition of continence was utilized. Results were compared to young children (5-11 years) and adolescents (12-19 years). Statistical analysis compared cohorts by gender, ethnicity, SB type, lesion level, insurance status, educational attainment, employment status, and continence.5250 SB patients were included; 1372 (26.1%) were adults. 45.8% of adults did not take medication, but 76.8% performed clean intermittent catheterization. Continence was lower in adults with myelomeningocele (MMC) (45.8%) versus those with non-MMC SB (63.1%) (p<0.0001). Continence rates were higher in older age cohorts for MMC patients (p<0.0001) but not non-MMC patients (p=0.1192). Bladder management and histories of urologic surgery varied among age groups. On univartiate analysis with SB-related or socio-economic variables, continence was significantly associated with educational level, but on multivariable logistic regression analysis, bladder continence was significantly associated with employment status only.Bladder management techniques differ between adults and younger patients with SB. Bladder continence outcomes were better in adults with nearly one-half reporting continence. Continence was significantly associated with employment status in adults 25 years or older.
Wiener, JS, Suson, KD, Castillo, J, Routh, JC, Tanaka, S, Liu, T, Ward, E, Thibadeau, J, Joseph, D, and National Spina Bifida Patient Registry, . "Bladder Management and Continence Outcomes in Adults with Spina Bifida: Results from the National Spina Bifida Patient Registry 2009-15." The Journal of urology (March 24, 2018).