Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Division of Urology, BC Children's Hospital, Vancouver, British Columbia, Canada.
J Urol. 2024 Aug;212(2):362-371. doi: 10.1097/JU.0000000000004013. Epub 2024 May 3.
We sought to assess associations between health-related quality of life (QOL), bladder-related QOL, bladder symptoms, and bladder catheterization route among adolescents and young adults with spina bifida.
Clinical questionnaires administered to individuals ≥ 12 years old requiring catheterization between June 2019 to March 2020 in a spina bifida center were retrospectively analyzed. Questionnaires were completed in English or Spanish independently or with caregiver assistance. Medical records were reviewed for demographic and clinical characteristics. Primary exposure was catheterization route (urethra or channel). Primary outcome was health-related QOL, measured by Patient-Reported Outcomes Measurement Information System Pediatric Global Health 7 (PGH-7). Secondary outcomes were bladder-related QOL and bladder symptoms, measured by Neurogenic Bladder Symptom Score (NBSS). Nested, multivariable linear regression models assessed associations between catheterization route and questionnaire scores.
Of 162 patients requiring catheterization, 146 completed both the PGH-7 and NBSS and were included. Seventy-three percent were catheterized via urethra and 27% via channel. Median age was 17.5 years (range 12-31), 58% of patients were female, and 80% had myelomeningocele. Urinary incontinence was more common among those who catheterized via urethra (60%) compared to channel (33%). On adjusted analyses, catheterization route was not significantly associated with PGH-7 or NBSS bladder-related QOL scores. More bladder symptoms were associated with worse bladder-related QOL. Patients who catheterized via channel had fewer bladder symptoms than those who catheterized via urethra.
Catheterization route was not significantly associated with QOL. Though catheterization via channel was associated with fewer bladder symptoms, only degree of current bladder symptoms was significantly associated with bladder-related QOL.
我们旨在评估在患有脊柱裂的青少年和年轻人中，健康相关生活质量（QOL）、膀胱相关 QOL、膀胱症状和膀胱置管途径之间的关系。
对 2019 年 6 月至 2020 年 3 月期间在脊柱裂中心需要置管的年龄≥12 岁的个体进行回顾性分析，使用临床问卷进行评估。问卷以英语或西班牙语独立或在照顾者的帮助下完成。回顾了病历以获取人口统计学和临床特征。主要暴露因素是置管途径（尿道或通道）。主要结局是健康相关生活质量，通过患者报告的结果测量信息系统儿科全球健康 7 （PGH-7）进行测量。次要结局是膀胱相关 QOL 和膀胱症状，通过神经源性膀胱症状评分（NBSS）进行测量。嵌套的多变量线性回归模型评估了置管途径与问卷评分之间的关联。
在需要置管的 162 名患者中，有 146 名患者完成了 PGH-7 和 NBSS 并被纳入研究。73%的患者通过尿道置管，27%的患者通过通道置管。中位年龄为 17.5 岁（范围 12-31），58%的患者为女性，80%的患者为脊髓脊膜膨出。通过尿道置管的患者中尿失禁更为常见（60%），而通过通道置管的患者中尿失禁更为常见（33%）。在调整后的分析中，置管途径与 PGH-7 或 NBSS 膀胱相关 QOL 评分无显著相关性。更多的膀胱症状与更差的膀胱相关 QOL 相关。通过通道置管的患者膀胱症状少于通过尿道置管的患者。
置管途径与 QOL 无显著相关性。虽然通过通道置管与较少的膀胱症状相关，但只有当前膀胱症状的严重程度与膀胱相关 QOL 显著相关。
