Abstract
Study design
Prospective observational.
Aim
The aim of this study was to analyse changes in bladder and bowel management methods in persons with long-standing spinal cord injury (SCI).
Setting
Two spinal centres in UK.
Method
Data were collected through interviews and examinations between 1990 and 2010 in a sample of persons injured more than 20 years prior to 1990.
Results
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, 80% were male, 37.7% had tetraplegia AIS grade A, B, or C, 44.7% paraplegia AIS A, B, or C, and 17.6% an AIS D grade regardless of level. In all, 50.6% reported having changed their bladder method, 63.1% their bowel method, and 40.5% both methods since they enroled 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.
Conclusions
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.
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Acknowledgements
We authors thank all the participants for taking part in the study, and staff at the collaborating spinal centres at Stoke Mandeville and Southport Hospitals, UK. Over the years, the study was financially supported by the following funders: 1990 and 1996—National Institute on Disability and Rehabilitation Research (NIDRR), USA; 1993—Centers for Disease Control and Prevention (CDC), USA; 1999 and 2002—Ontario Neurotrauma Foundation, Canada; 2006—Buckinghamshire Hospitals NHS Trust Charitable Spinal Fund, UK; David Tolkien Trust Fund, UK; Southport and Ormskirk Hospital Spinal Injuries Centre Endowment Fund, UK; 2010—Buckinghamshire Healthcare NHS Trust Charitable Spinal Fund, UK and Ann Masson Legacy for Spinal Research Fund, UK.
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Savic, G., Frankel, H.L., Jamous, M.A. et al. Long-term bladder and bowel management after spinal cord injury: a 20-year longitudinal study. Spinal Cord 56, 575–581 (2018). https://doi.org/10.1038/s41393-018-0072-4
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DOI: https://doi.org/10.1038/s41393-018-0072-4
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