Quality of Life and Bladder Management post Spinal Cord Injury: A Systematic Review

To explore the relationship between neurogenic bladder management techniques and quality of life (QoL) among individuals with spinal cord injury (SCI). A key terms literature search was conducted in multiple electronic databases (i.e., MEDLINE, CINAHL, EMBASE, and PsycINFO). Studies published up to and including May 2013 were reviewed and evaluated based on the following criteria: (1) full-length journal article published in the English language; (ii) human subjects ≥18 years; (iii) ≥?50 % of subjects had a SCI; (iv) results on QoL, as it related to bladder management method, were reported for at least three subjects. A total of 422 articles were extracted and upon review of titles and abstracts, 7 studies met the inclusion criteria. There were two level 2 cohort studies and five level 5 observational studies. Sample sizes ranged from 37 to 282 with an average of 117.1 individuals per study. All participants were at least six months post injury. Bladder management methods used included intermittent (patient/attendant), indwelling (suprapubic/transurethral), and condom catheterization, micturition assistive maneuvers, and electrical stimulation. Normal voiders scored better in all QoL measure domains compared to other management methods. Those using attendant intermittent and indwelling catheterization scored the poorest on the domains Personal Relationships, Emotions, and Mental Health. There is insufficient evidence to provide a definite conclusion as to the relationship between bladder management methods and QoL post SCI. However, individuals relying on others to aid in voiding may experience lower QoL compared to those who are independent.