How Do Surgical Interventions for Neurogenic Lower Urinary Tract Dysfunction Impact Quality of Life?

Area of Science:

• Urology
• Neurosurgery
• Quality of Life Research

Background:

• Adults with neurogenic lower urinary tract dysfunction (NLUTD) experience significant urinary symptoms impacting their quality of life (QOL).
• Surgical interventions are employed to manage NLUTD, but their effect on patient QOL requires thorough evaluation.

Purpose of the Study:

• To systematically review and summarize existing literature on quality of life (QOL) changes in adult patients undergoing surgical interventions for neurogenic lower urinary tract dysfunction (NLUTD).

Main Methods:

• A rapid systematic evidence review was conducted using EMBASE and MEDLINE databases.
• Included studies focused on adult patients (18+ years) with NLUTD who underwent surgery and had QOL measurements, prioritizing pre-post intervention designs.
• Data were extracted and synthesized qualitatively by multiple assessors.

Main Results:

• Twenty-six studies were included. Reconstructive surgery (n=94) showed 7%-28% QOL improvement with validated questionnaires.
• Urinary diversion (n=153) demonstrated 20%-60% improvement in bladder-specific QOL and 0%-25% in overall QOL.
• Stress incontinence surgeries (n=67) reported improvements in ICIQ and study-specific questionnaires.

Conclusions:

• The current literature provides limited evidence for QOL changes in adult NLUTD surgical patients.
• A significant lack of pre-post intervention studies and the frequent use of unvalidated outcome measures restrict robust conclusions.