Impacts of bladder managements and urinary complications on quality of life: Cross-sectional perspectives of persons with spinal cord injury living in Malaysia, Indonesia, and Thailand

The impact of bladder care and urinary complications on quality of life (QoL) in persons with spinal cord injury (SCI) who have neurogenic lower urinary tract dysfunction has not been elucidated, especially in those living in low-resource countries. This multinational cross-sectional survey was conducted in rehabilitation facilities in Malaysia, Indonesia, and Thailand. Community-dwelling adults with traumatic or non-traumatic SCI participating in the International Spinal Cord Injury Community Survey (InSCI) from 2017 to 2018 were enrolled. Data regarding bladder management/care, presence of bladder dysfunction, urinary tract infection (UTI), and QoL score were extracted from the InSCI questionnaire. The impact of bladder care and urinary complications on QoL was determined using univariable and multivariable regression analysis. Questionnaires from 770 adults were recruited for analysis. After adjusting for all demographic and SCI-related data, secondary conditions, as well as activity and participation factors, UTI was an independent negative predictive factor of QoL score (p = 0.007, unstandardized coefficients = -4.563, multivariable linear regression analysis, enter method). Among bladder care and urinary complication factors, UTI is the only factor negatively impacting QoL. These results address the importance of proper bladder management and UTI prevention in persons with SCI to improve their QoL