Abstract
Study design
Survey.
Objectives
To investigate the needs and priorities of people with spinal cord injury for managing neurogenic bladder and bowel function and to determine their willingness to adopt neuromodulation interventions for these functions.
Methods
Anonymous online survey. It was advertised by word-of-mouth by community influencers and social media, and by advertisement in newsletters of advocacy groups.
Results
Responses from 370 individuals (27% female, 73% male) were included. Bladder emptying without catheters was the top priority for restoring bladder function, and maintaining fecal continence was the top priority for restoring bowel function. The biggest concerns regarding external stimulation systems were wearing a device with wires connecting to electrodes on the skin and having to don and doff the system daily as needed. The biggest concerns for implanted systems were the chances of experiencing problems with the implant that required a revision surgery or surgical removal of the whole system. Respondents were willing to accept an external (61%) or implanted (41%) device to achieve improved bladder or bowel function.
Conclusions
Bladder and bowel dysfunction remain important unmet challenges for individuals living with SCI who answered our survey. These individuals are willing to accept some potential risks of nerve stimulation approaches given potential benefits. Additional consumer input is critical for guiding both research and translation to clinical use and personalized medicine.
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Data availability
The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
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Funding
This work was supported in part by the U.S. Department of Veterans Affairs Rehabilitation Research and Development Service RX001962. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.
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DB, GC, BF, JF, TJ, AK, AR, BGS, KBT, TW, and JW contributed equally to survey design and implementation. DB, AB, WD, RK, and JS contributed to data analyses and reporting. All co-authors contributed to results interpretation and manuscript preparation.
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KBT and BGS are co-authors and they work for Dignify Therapeutics Inc. and for Radiometer, respectively. These roles may present real or perceived conflict of interest.
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Bourbeau, D., Bolon, A., Creasey, G. et al. Needs, priorities, and attitudes of individuals with spinal cord injury toward nerve stimulation devices for bladder and bowel function: a survey. Spinal Cord 58, 1216–1226 (2020). https://doi.org/10.1038/s41393-020-00545-w
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DOI: https://doi.org/10.1038/s41393-020-00545-w
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