New score ‘reliable and valid’ for neurogenic bladder dysfunction

Feb 17 2014

By Joanna Lyford, Senior medwireNews Reporter

The Neurogenic Bladder Symptom Score (NBSS) is both valid and reliable for assessing urinary dysfunction in people with acquired or congenital neurogenic bladder, according to a study published online in the Journal of Urology.

A further benefit of the NBSS is that it can be used to assess specific domains of the condition, such as symptoms, complications and consequences for the patient.

In earlier work, a multidisciplinary team led by Blayne Welk (Western University, London, Ontario, Canada) developed the NBSS through a process of reviewing items from disease-specific quality-of-life instruments, urologic symptom-specific instruments and the neurogenic bladder literature.

Building on qualitative interviews with patients and expert review, the team chose 24 items to include in the score. These included, among others, the frequency and quantity of urine leakage; the impact of leakage on health and everyday activities; the frequency and severity of urinary tract infections; frequency of bladder and kidney stones; and use and efficacy of bladder medications.

For the present study, the researchers administered the NBSS, along with other established questionnaires, to 230 patients with spinal cord injury (35%), multiple sclerosis (59%), or congenital neurogenic bladder (6%).

The median score on the NBSS was 19 out of a possible 74. Factor analysis indicated that the score had three distinct domains: incontinence, storage and voiding symptoms and consequences.

Cronbach alpha values indicated that the NBSS was internally consistent both overall and in its three domains; furthermore, the score was found to be reliable over a 1-week retest period and valid, correlating strongly with scores on other established measures.

Welk and co-authors also note that the NBSS was successfully self-administered by patients, using standard language and with few missing responses.

“The NBSS is a reliable and valid tool to measure the symptoms and consequences of neurogenic bladder dysfunction,” the researchers conclude.

They add: “Previous studies have generally focused on incontinence, however the 3 domains in the NBSS better represent the spectrum of neurogenic bladder dysfunction, and the associated complications. Each of the domains of the NBSS are valid and reliable, and may be used individually, depending on the clinical need.”

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