Longitudinal Study of Bladder Continence in Patients with Spina Bifida in the National Spina Bifida Patient Registry

Tiebin Liu, Lijing Ouyang, Judy Thibadeau, John S. Wiener, Jonathan C. Routh, Heidi Castillo, Jonathan Castillo, Kurt A. Freeman, Kathleen J. Sawin, Kathryn Smith, Alexander Van Speybroeck, Rodolfo Valdez

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Purpose: Achieving bladder continence in individuals with spina bifida is a lifetime management goal. We investigated bladder continence status through time and factors associated with this status in patients with spina bifida. Materials and Methods: We used National Spina Bifida Patient Registry data collected from 2009 through 2015 and applied generalized estimating equation models to analyze factors associated with bladder continence status. Results: This analysis included 5,250 participants with spina bifida in a large, multi-institutional patient registry who accounted for 12,740 annual clinic visit records during the study period. At last followup mean age was 16.6 years, 22.4% of participants had undergone bladder continence surgery, 92.6% used some form of bladder management and 45.8% reported bladder continence. In a multivariable regression model the likelihood of bladder continence was significantly greater in those who were older, were female, were nonHispanic white, had a nonmyelomeningocele diagnosis, had a lower level of lesion, had a higher mobility level and had private insurance. Continence surgery history and current management were also associated with continence independent of all other factors (adjusted OR and 95% CI 1.9, 1.7–2.1 and 3.8, 3.2–4.6, respectively). The association between bladder management and continence was stronger for those with a myelomeningocele diagnosis (adjusted OR 4.6) than with nonmyelomeningocele (adjusted OR 2.8). Conclusions: In addition to demographic, social and clinical factors, surgical intervention and bladder management are significantly and independently associated with bladder continence status in individuals with spina bifida. The association between bladder management and continence is stronger in those with myelomeningocele.

Original languageEnglish (US)
Pages (from-to)837-843
Number of pages7
JournalJournal of Urology
Issue number3
StatePublished - Mar 2018


  • longitudinal studies
  • spinal dysraphism
  • urologic surgical procedures

ASJC Scopus subject areas

  • Urology


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