notes (if applicable):
|Why this is important:- The range of bladder management strategies available to manage lower urinary tract dysfunction in neurological disease includes permanent urethral catheterisation and suprapubic catheterisation, intermittent self-catheterisation, penile sheath collection systems and pads. However, there is very sparse evidence about which strategies are most acceptable to patients and/or their family members and carers. The current research base relates mainly to the spinal injury population but may be relevant to people with other neurological diseases.
Bladder management strategies are a long-term treatment with implications for maintaining
health and quality of life. In order to make informed choices about the most appropriate method
of bladder management, patients and/or their family members and carers require information
about the risks and benefits of the available options. There is currently little evidence about
which methods are most likely to produce long-term complications (renal impairment, urinary stones and infections, hydronephrosis, bladder malignancy). The effect on quality of life for patients and/or their family members and carers of different bladder management strategies is not known. There are methodological difficulties due to the heterogeneity of the population with neurological disease, the long time course of treatments and the presence of cognitive impairment in some sub-populations.
Proposed studies could include prospective cohort studies of disease-specific populations
examining the effect of each method on quality of life using both generic and disease-specific
assessment methods. In addition, prospective screening for complications including renal
impairment, stone formation and infection should be carried out and comparisons made for each bladder management method. Particular emphasis should be placed on quality-of-life outcomes for family members and carers, especially for those looking after people with cognitive impairment.