Bladder management is the top health concern among adults with a spinal cord injury

Introduction and Objective: Individuals with spinal cord injury (SCI) commonly experience secondary complications though it is not known how they prioritize these different health domains. Using the Neurogenic Bladder Research Group (NBRG) SCI registry, our objective was to identify the top health concerns of individuals with SCI and identify factors that may be associated with these choices with particular focus on urologic issues that participants face. Methods: Participants in the NBRG registry were asked: “What are the top 3 problems that affect you on a daily basis?” Urinary symptoms and QoL were assessed with the Neurogenic Bladder Symptom Score (NBSS). Multivariate regression was used to identify factors related to selecting a top ranked health issue. Results: Among our 1461 participants, 882 (60.4%) were men and the median age was 45.1 years (IQR 25.3−64.9). Bladder management was the most commonly top ranked primary issue (39%) followed by pain (16.4%) and bowel management (11.6%). Factors associated with ranking bladder management as the primary concern included years since injury (OR 1.01 [1.00−1.02], p = 0.042), higher (worse) total NBSS (OR 1.05 [1.03−1.06], p < 0.001), and higher (worse) NBSS QoL (OR 1.25 [1.12−1.41], p < 0.001). Reporting chronic pain on a daily basis was associated with ranking pain as the primary health concern (OR 41.7 [15.7−170], p < 0.001). Conclusions: In this cohort, bladder management was ranked as the top health issue and increasing time from injury was associated with increased concern over bladder management. More bladder symptoms were also associated with ranking bladder management as a primary concern while bladder management method and urinary tract infections rate were not.