Evidence map›Paper›PMID 39912231›Full record

Observational studyNeurourology and urodynamics2025

Impact of Bladder Management Strategies on Autonomic Dysreflexia Severity in People With Spinal Cord Injuries.

Rita Palanjian, Blayne Welk, Jeremy B Myers, Sara M Lenherr, Sean P Elliott, Diana O'Dell, John T Stoffel

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Neurourology and urodynamics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Urogenital dysfunction in neurological diseases.Nature reviews. Neurology · 2026
    Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rita PalanjianUniversity of Michigan Medical School, Ann Arbor, Michigan, USA.ORCID http://orcid.org/0000-0003-4093-6746
Blayne WelkDepartment of Surgery, University of Western University, London, Ontario, Canada.
Jeremy B MyersDepartment of Urology, University of Utah, Salt Lake City, Utah, USA.ORCID http://orcid.org/0000-0002-5786-1552
Sara M LenherrDepartment of Urology, University of Utah, Salt Lake City, Utah, USA.
Sean P ElliottDepartment of Urology, University of Minnesota, Minneapolis, Minnesota, USA.ORCID http://orcid.org/0000-0002-5280-2449
Diana O'DellUniversity of Michigan Medicine, Ann Arbor, Michigan, USA.
John T StoffelDepartment of Urology, University of Michigan Medicine, Ann Arbor, Michigan, USA.ORCID http://orcid.org/0000-0002-5503-4940

Funding

Patient Centered Outcomes Research Institute Award-CER14092138.
6 · The paper itself

Abstract

purposeWe investigated whether severity of autonomic dysreflexia (AD) was associated with more patient-reported bladder and bowel symptoms and compared AD severity by bladder management strategy in people with spinal cord injury (SCI).

methodsThe Neurogenic Bladder Research Group SCI Registry is a prospective study which evaluated quality of life after SCI. Bladder and bowel symptoms were assessed through Neurogenic Bladder Symptom Score and Neurogenic Bowel Dysfunction score, respectively. AD severity was assessed with the Autonomic Dysreflexia Following Spinal Cord Injury (ADFSCI) instrument. Bladder management was classified as volitional voiding, clean intermittent catheterization (CIC), indwelling catheter (IDC), and surgery (augmentation and diversion).

resultsAD scores were identified for 1473 people. The mean age was 45. Bladder management was CIC in 754 (51%), IDC in 271 (18%), surgery in 195 (13%) and voiding in 259 (18%). On univariate analysis, higher ADFSCI scores occurred with complete injuries (3.1 vs 3.4, p = 0.03), cervical/thoracic injuries (3.8 vs 1.5, p < 0.0001), and chronic pain (3.9 vs 2.9, p = 0.0004). IDC (5.2) and surgery (4.5) had higher ADFSCI scores than CIC (3.0) and volitional voiding (2.8) (p < 0.0001). Sub-analysis showed bladder augmentation had significantly higher ADSCI scores than diversion (4.7 vs 3.7, p = 0.03). On multivariate analysis, level of injury, bladder management, and bowel and bladder symptoms remained associated with worse AD.

conclusionLevel of injury, age, worse bowel and bladder symptoms and bladder management type were associated with higher AD scores. Bladder management with surgery, particularly bladder augment, and IDC had associated greater AD symptoms compared to CIC or voiding.

trial registrationclinicaltrials.gov NTC06216081 and HSRP20153564, U.S. National Library of Medicine, wwwcf.nlm.nih.gov.

Indexed as

Autonomic DysreflexiaSpinal Cord InjuriesUrinary BladderUrinary Bladder, NeurogenicAdultAgedFemaleHumansIntermittent Urethral CatheterizationMaleMiddle AgedNeurogenic BowelProspective StudiesQuality of LifeRegistriesSeverity of Illness Indexautonomic dysreflexiabladder managementneurogenic bladderneurogenic bowelspinal cord injury

Identifiers

PMID39912231
PMCPMC12018645

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.