High prevalence of incontinence among young adults with spina bifida: description, prediction and problem perception.

Verhoef M, Lurvink M, Barf HA, Post MW, van Asbeck FW, Gooskens RH, Prevo AJ.

Rehabilitation Centre De Hoogstraat, 3583 TM Utrecht, The Netherlands.  Spinal Cord. 2005 Jun;43(6):331-40.

STUDY DESIGN: Cross-sectional study.

OBJECTIVES: To study the prevalence of incontinence, problem perception and determinants of urinary and faecal incontinence in young adults with spina bifida. SETTING: Nation-wide study in the Netherlands.

PARTICIPANTS: A total of 179 of 350 invited patients participated, including 37 patients with spina bifida occulta and 142 with spina bifida aperta, of whom 119 had hydrocephalus; 41% were male and mean age was 20.4 (range 16-25 years). METHODS: Data were collected from interviews, physical examination, neuropsychological tests and medical records.

RESULTS: Urinary and faecal incontinence was common in young adults with spina bifida (60.9 and 34.1%, respectively), regardless of the bladder and bowel management they used. The majority of urinary and faecal incontinent patients perceived this as a problem (69.7 and 77.0%, respectively). Spina bifida aperta, hydrocephalus and a level of lesion of L5 or above were associated with patients suffering from urinary and/or faecal incontinence. Predictors of perceiving urinary incontinence as a problem were, in addition to being incontinent, not having hydrocephalus and having a level of lesion of L5 or above. The only predictor of perceiving faecal incontinence as a problem was the frequency of incontinence.

CONCLUSION: A majority of young adults with spina bifida suffer from urinary and faecal incontinence and most of them perceive their incontinence as a problem. Therefore, further efforts are important to improve urinary and faecal continence.