The Current Epidemiology of Urinary Incontinence and Urinary Tract Infections After Spinal Cord Injury-A Model Systems Spinal Cord Injury Examination (2016-2021).

Introduction

Neurogenic bladder disorders after spinal cord injury (SCI) are often problematic with urinary incontinence (UI) and recurrent urinary tract infections (UTIs) contributing to patient morbidity. Our study objective was to provide a current snapshot of the frequency of UI and UTIs in the SCI population while also quantifying their association with hospitalization.

Methods

The National Spinal Cord Injury Database (2016-2021) was accessed for persons within five years of injury. The self-reported frequency of UI in the last month (none, daily, weekly, monthly), the number of UTIs requiring antibiotic treatment, and the number of hospitalizations (including reason) in the prior year were evaluated.

Results

Our cohort comprised 5106 individuals within 5 years of SCI. Approximately 40% reported UI in the past month and over 50% had a UTI requiring antibiotics in the past year. Incontinence was significantly more frequent in those performing clean intermittent catheterization (CIC) (52% overall, 17% daily) compared to indwelling catheters (29% overall) or volitional void (22% overall) (p < 0.001 for each). Conversely, UTIs were most common in those using indwelling catheters (79% with at least one UTI) or CIC (70%) compared to diapers/condom catheters (46%) or volitional void (19%) (p < 0.001 for each). Increasing UI and UTI occurrences were both associated with an increased frequency of hospitalization in the prior year.

Conclusions

UI and UTIs are common problems after SCI. While differing frequencies of UI and UTI are present based on bladder management, the overall frequency suggests that a continued emphasis on prevention is needed to potentially increase quality of life and decrease hospitalization.