Bladder-sphincter disorders and quality of life of traumatic brain injury: Tunisian experience.

OBJECTIVE: The aim of our study was to assess the bladder and sphincter function after brain injury (BI) and to review their association with quality of life (QOL).

MATERIAL/PATIENTS AND METHODS: We conducted a cross-sectional study, including patients referred to physical and rehabilitation medicine department at the Med Kassab Institute of Orthopedics. The initial gravity data were collected. The bladder-sphincter assessment included evaluation of the urine drain mode, the irritative disorders, obstructive disorders, disorders of transit and the existence of secondary anal lesions. The assessment of QOL was conducted by visual analog scale (VAS). We sought an association between the bladder-sphincter disorders (BSD) and QOL.

RESULTS: Thirty-two patients, 24 men and 8 women, mean age 23.93years assessed after BI. Most patients (90%) had spontaneous urination, three performed intermittent self-catheterization, six had an overactive bladder syndrome, and three had dysuria. Two of the evaluated subjects had constipation and one patient had chronic diarrhoea. Secondary anal lesions were external haemorrhoids for one patient and an anal fissure for another. The mean VAS of QOL was 5.59/10. Patients with added BSD had a poorer QOL and a more pronounced impact on daily life with a statistically significant difference (P<0.05).

DISCUSSION-CONCLUSION: After BI, the bladder-sphincter profile of patients appears heterogeneous. Their presence alters more QOL. All BI patients having a rehabilitation care should have a screening of these problems in order to preserve the upper urinary tract and to improve the autonomy and the QOL.