Coping with Bowel and Bladder Dysfunction After SCI: A Comparison between India and Canada

Abstract

Abstract Study Design: A cross-sectional design. Objectives:This is an exploratory study to better understand how individuals with SCI in these diverse countries are managing and coping with bladder and bowel dysfunction. Setting: Our project is a collaboration between two centers: the International Collaboration on Repair Discoveries (ICORD)/Blusson Spinal Cord Center in Vancouver, Canada and the Indian Spinal Injuries Centre in New Delhi, India. Methods: Data from thirty-three participants was analyzed. Participants completed an online questionnaire that included demographic information and assessed bowel and bladder functioning using the Neurogenic Bowel Dysfunction (NBD) score, Wexner Incontinence score (WIS), Neurogenic Bladder Symptom Score (NBSS) and the Incontinence QOL (I-QOL). Continuous data were compared using t-tests; for not normally distributed data Mann-Whitney U tests used. For evaluation of association between categorical variables, Fisher’s exact test or Chi-square was used. Results: The Canadian sample reported higher NBD total scores indicating more severe bowel dysfunction, less daily bowel movements, and was more likely to experience uneasiness, headaches, and perspiration during bowel movements. The NBSS indicated a higher proportion of the Indian sample was unsatisfied or unhappy with their bladder function. The distribution of the WIS and I-QOL scores were the same across both countries. Conclusion: Potential explanations for differences include diet, methods of management, financial resources, as well as patient and caregiver education. These variables are heavily influenced by cultural, geographical, and economic circumstances.