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Autonomous bladder training for neurogenic bladder: a randomized controlled trial
Yue Yang1, Lianchi Li2, Jing Ye1
1Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China; Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Department of Rehabilitation Medicine, West China Hospital, Sichuan University/WestChina School of Nursing, Sichuan University, Chengdu, China.
Autonomous bladder training significantly improved bladder emptying and reduced symptoms in patients with neurogenic bladder. This intervention offers a promising, non-invasive approach to managing neurogenic bladder complications.
Area of Science:
- Urology
- Rehabilitation Medicine
- Neuroscience
Background:
- Neurogenic bladder significantly impairs bladder emptying, leading to complications and reduced quality of life.
- Current management often involves routine care, with limited options for improving bladder function.
Purpose of the Study:
- To evaluate the efficacy of structured multimodal autonomous bladder training in improving bladder function for patients with neurogenic bladder.
- To assess the impact of this training on urodynamic parameters and patient-reported outcomes.
Main Methods:
- A single-centre randomized controlled trial involving 168 adults with neurogenic bladder.
- Participants were assigned to either autonomous bladder training plus routine care or routine care alone for 4 weeks.
- Key outcomes included changes in post-void residual urine volume (RUV), urodynamic parameters, and the Neurogenic Bladder Symptom Score (NBSS).
Main Results:
- Autonomous bladder training led to a significant reduction in RUV compared to routine care (-55.8 mL difference).
- Improvements were also observed in maximum urinary flow rate, detrusor pressure, and NBSS.
- A substantial proportion (79.8%) of the intervention group achieved ≥50 mL RUV reduction, compared to 42.9% in the control group. Symptomatic urinary tract infections requiring antibiotics were less frequent in the intervention group (9.5% vs 27.4%).
Conclusions:
- Autonomous bladder training effectively improved short-term urodynamic and patient-reported outcomes in neurogenic bladder.
- Exploratory follow-up suggested partial maintenance of benefits at 12 weeks.
- Further multicentre trials are recommended to confirm these findings, particularly regarding infection rates due to incomplete culture confirmation.
