Science Alert: Bladder and bowel care in focus – from children to the elderly

Posted by Maria Åberg Håkansson, March 31, 2017

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Bladder and bowel problems are common and of high importance for people with spinal cord injury and other neurogenic damage.

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Even in people without a pronounced disability, they can be of central importance, as some new research findings indicate.

Bladder capacity and functionality appears to change with age; a recent study shows that while this can sometimes resolve itself without intervention, it can also become a real problem in elderly men.

In children, on the other hand, it seems to be a potentially underdiagnosed problem. One research focus is on how best to teach children (and their parents) to address bladder and bowel (dys)function. The results suggest that new technology has an important role to play and that the time may have come to re-evaluate the classic individual training given by healthcare professionals.

In spinal cord injury, we know that bladder and bowel symptoms are of high importance and that they need to be addressed properly. New research provides tools for proper evaluation and classification of bowel dysfunction, and we also see examples of how different bladder management methods can be linked to quality of life among people with spinal cord injury.

You will find a summary from these articles in this blog post! 


Natural history of non-neurogenic overactive bladder and urinary incontinence over 5 years in community-dwelling older men: The concord health and aging in men project.

https://www.ncbi.nlm.nih.gov/pubmed/26756291

Author and Origin

Noguchi N, Chan L, Cumming RG, Blyth FM, Handelsman DJ, Waite LM, Le Couteur DG, Naganathan V. Australia

Summary

Observational prospective study of overactive bladder and urinary incontinence in 488 men aged 70 and older and without neurological diseases or prostate cancer. Observations were made at baseline, at 2 years and at a 5-year follow-up.

Conclusions

Of the men with overactive bladder, 29% received treatment and of the remaining men, 33% had reduced symptoms without any treatment.

Comments

Study showing data on prevalence of non-neurogenic overactive bladder and urinary incontinence among men aged over 70 years.

  


Bladder and bowel dysfunction in children: An update on the diagnosis and treatment of a common, but underdiagnosed pediatric problem.

http://dx.doi.org/10.5489/cuaj.4411

Author and Origin 

Dos Santos J, Lopes RI, Koyle MA. Canada

Summary

Review addressing bladder and bowel dysfunction in children.

Conclusions

Bladder and bowel dysfunction among children is common. It is important to treat it, as it can lead to severe complications (e.g. urinary tract infection and vesicoureteral re ux) and presents a significant psychosocial burden.

Comments

Study highlighting the underdiagnosed problem of bladder and bowel dysfunction in children.

This publication is described further in the highlight section.

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Bladder Training Video versus Standard Urotherapy for Bladder and Bowel Dysfunction: A Noninferiority Randomized, Controlled Trial.

http://dx.doi.org/10.1016/j.juro.2016.08.089

Author and Origin

Braga LH, Rickard M, Farrokhyar F, Jegatheeswaran K, Brownrigg N, Li C, Bansal R, DeMaria J, Lorenzo AJ. Canada

Summary

Randomized controlled trial in 143 children (aged 5 to 10 years), comparing two educational approaches for bladder/bowel care.

Conclusions

Results showed that a training video was as effective as standard individual urotherapy in improving bladder/bowel symptoms. The video had the advantage of being available as often as necessary.

Comments

Study comparing two educational approaches for improving bladder and bowel symptoms in children.

  


New device for intermittent emptying of the bladder in female children and adolescents: A pilot study.

http://dx.doi.org/10.1016/j.jpurol.2016.12.030

Author and Origin 

Lima SVC, Vilar FO, Lustosa ES, Aragão DCC, Calisto FCFS, Pinto FCM. Brazil

Summary

Observational prospective study of a new device for intermittent bladder voiding tested in 25 children and adolescents with spina bifida with urinary incontinence.

Conclusions

The device was implanted and placed in the bladder neck. After 6 months, 86% tolerated the device while 16% experienced complications. Results indicated improvements in incontinence and quality of life.

Comments

Study describing initial research on a new implantable device for intermittent bladder voiding used by children and adolescents with incontinence, secondary to spina bifida.

 


International spinal cord injury bowel function basic data set (Version 2.0).

https://www.ncbi.nlm.nih.gov/pubmed/28195229

Author and Origin

Krogh K, Emmanuel A, Perrouin-Verbe B, Korsten MA, Mulcahey MJ, Biering-Sorensen F. International

Summary

A major revision of the bowel function data set 1.0 from 2009. The data set consists of 16 items to align data capture of bowel issues for persons with spinal cord injury.

Conclusions

The bowel function data set 1.0 needed revision due to new knowledge and clinical experience. This has now been done.

Comments

An international SCI bowel function basic data set to align data capture for both clinical and research work.

  


Differences in bladder-related quality of life after spinal cord injury.

http://dx.doi.org/10.1002/nau.23228

Author and Origin 

Lenherr SM, Patel D, Gor RA, Suku- mar S, Elliott SP, Jha A, Presson AP, Zhang C, Rosenbluth J, Stoffel JT, Welk B, Myers JB. US

Summary

Observational prospective study in 609 individuals with spinal cord injury (SCI) investigating quality of life related to neurogenic bladder management.

Conclusions

Quality of life seems dependent on bladder management method but varies with measuring tool. For example, people with chronic catheter or stoma (23%) had lower quality of life as a result of more complications.

Comments

Conference abstract indicating that quality of life is dependent on neurogenic bladder management method.

 


Transanal irrigation in neurogenic bladder and bowel management from paediatric to adult age.

http://onlinelibrary.wiley.com/doi/10.1002/nau.23037/abstract

Author and Origin

Masnata G, Chila L, Esu F, Carta R, Calarota A, Melis G, Manca V. Italy

Summary

A study to investigate the effect of using transanal irrigation (Peristeen) on neurogenic bowel dysfunction (NBD) score and quality of life (QoL) in 14 patients with neurogenic bladder and bowel.

Conclusions

Patients reported improvement in NBD score and QoL.

Comments

Conference abstract of a study confirming the effectiveness of transanal irrigation in patients with neurogenic bladder and bowel.

  


A case-control comparison of direct healthcare-provider medical costs of chronic idiopathic constipation and irritable bowel syndrome with constipation in a community-based cohort.

https://www.ncbi.nlm.nih.gov/pubmed/27783533

Author and Origin 

Herrick LM, Spalding WM, Saito YA, Moriarty J, Schleck C. UK

Summary

A study to compare medical costs for 115 patients with irritable bowel syndrome with constipation (IBS-C) and 365 patients with chronic idiopathic constipation to matched controls (1:2). The comparison was made over a 2-year period.

Conclusions

Patients with IBS-C and chronic idiopathic constipation had significantly higher outpatient costs for the 2-year period compared with controls. IBS-C patients also had higher emergency treatment costs than the general population.

Comments

Study showing that there are substantial costs associated with IBS-C and chronic idiopathic constipation.

 


 

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This blog post is an extract of the Science Alert from March 2017 (76040-USX-1703)

Topics: Science Alert, Bladder and bowel interaction, Bowel management