Faecal, urinary incontinence independently predict lower QoL in adults with spina bifida
Although both faecal and urinary incontinence predict lower health-related quality of life (QoL) in adults with spina bifida, each type is independent and affects QoL differently, a recent study has found. For instance, health-related QoL is lower with an increasing amount of urinary incontinence, but the impact of faecal incontinence on health-related QoL is more uniform regardless of frequency or amount.
“We previously reported that the self-reported amount of urinary incontinence is the main predictor of lower health-related quality of life in adults with spina bifida,” according to researchers, who assessed the impact of faecal incontinence on health-related QoL in this current study after correcting for urinary incontinence.
An online survey conducted from 2013 to 2014 was completed by an international sample of adults (n=518; mean age 32 years; 33 percent male) with spina bifida. Overall, faecal incontinence was recorded in 55.4 percent of participants, urinary incontinence in 76.3 percent and both types in 46.9 percent.
Researchers then evaluated faecal incontinence in the last 4 weeks using clean intervals (less than 1 day, 1 to 6 days, 1 week or longer, or no faecal incontinence), amount (a lot, medium, a little or none), number of protective undergarments worn daily and similar variables for urinary incontinence.
The authors used linear regression (all outcomes 0 to 100) and validated instruments such as Quality of Life Assessment in Spina bifida for Adults (QUALAS-A) for spina bifida specific health-related QoL and the generic WHO Quality of Life, short form (WHOQOL-BREF).
Based on multivariate analysis, an association existed between faecal incontinence and lower bowel and bladder health-related QoL across all amounts (‒16.2 for a lot, ‒20.9 for medium and ‒18.5 for little vs none; p<0.0001); clean intervals were not significant (‒4.0 to ‒3.4; p≥0.18).
On the other hand, an increased amount of urinary incontinence predicted lower health-related QoL (‒27.6 for a lot, ‒18.3 for medium and ‒13.4 for little vs none; p<0.0001). There was no association between dry intervals <4 hours and lower health-related QoL (‒4.6; p=0.053), but the use of undergarments was associated with it (‒7.5 to ‒7.4; p≤0.01).
Additionally, both faecal and urinary incontinence were associated with lower WHOQOL-BREF scores, according to researchers.