Urinary Symptoms Among People With Neurogenic Lower Urinary Tract Dysfunction (NLUTD) Vary by Bladder Management

Area of Science:

• Urology
• Neuroscience
• Clinical Assessment

Background:

• Neurogenic lower urinary tract dysfunction (NLUTD) affects bladder control.
• Current assessment of urinary symptoms may not adequately account for diverse bladder management strategies.

Purpose of the Study:

• To determine if urinary symptom assessment and decision-making in NLUTD should be dependent on the method of bladder management.
• To develop and validate specific urinary symptom questionnaires based on bladder management type.

Main Methods:

• Development of three Surveys of Urinary Symptoms associated with NLUTD (USQNBs), tailored for indwelling catheter (IDC), intermittent catheter (IC), and voiding (V) management.
• Qualitative assessment of items by subject matter experts and unsupervised structural learning to identify and classify symptom items.
• Categorization of items into clinically actionable, bladder-specific, urine quality, or constitutional.

Main Results:

• A core of 10 NLUTD urinary symptoms was identified, comprising clinically actionable, bladder-specific, urine quality, and constitutional items.
• Each management method (IDC, IC, V) had unique symptom items (9, 11, and 8, respectively).
• A single decision-making protocol was applicable across all instruments.

Conclusions:

• Ten core urinary symptoms in NLUTD are independent of bladder management, but a similar number are dependent.
• Urinary symptom assessment for individuals with NLUTD necessitates specificity to the bladder management method.
• The developed USQNBs provide a tailored approach to symptom assessment in NLUTD.