Emerging Approaches For Bowel And Bladder Management Following Spinal Cord Injury

Executive Summary:

Bowel and bladder dysfunction (BBD) has a significant impact on the quality of life of people with spinal cord injury (PwSCI). The prevalence of BBD in PwSCI is not well known. Whilst not all people with an SCI will be affected, those affected may experience either a loss of bowel control, severe constipation, urinary incontinence, infection or possibly a combination of these conditions.

BBD has not only physical consequences but also psychological consequences that impact on the person's social life, their independence and their ability to maintain employment. Even for PwSCI who do not experience incontinence, the fear of it potentially occurring can cause anxiety, social embarrassment or isolation, contributing to a poorer quality of life.

Several interventions exist for the management of BBD in PwSCI; however, these interventions have not changed significantly over the last 20 years with much of the evidence that guides current practice based on trials with only a small number of patients.

More recently, new areas of promise have emerged in the management of BBD in SCI, such as the use of assistive devices, irrigation techniques and pharmacological treatments such as botulinum toxin A (Botox). Whilst more research is still needed, uptake of promising and emerging therapies into practice needs to be considered to ensure that those who need the treatment most will be the ones to benefit. How research can be progressed from the "bench-to-bedside" requires innovative thinking from experts in the area of spinal cord research and treatment.

This NTRI Forum aimed to:

  1. To develop a shared understanding of the impact of bowel and bladder issues for those with SCI. More specifically, a. Bowel and bladder problems have a significant impact on quality of life; and b. Management has not changed significantly in the last 20 years.
  2. To assess and inform emerging, innovative research approaches in the management of BBD for PwSCI living in the community (dissemination);
  3. To identify the challenges and barriers of 'bench-to-bedside' research in this area;
  4. To develop a collaborative approach with other researchers and funding bodies in associated areas to advance the field (collaboration).

Date: June 2014


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