{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:18:12Z","timestamp":1785176292642,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Buddhist Tzu Chi Medical Foundation","award":["TCMF-MP-110-03-01"],"award-info":[{"award-number":["TCMF-MP-110-03-01"]}]},{"name":"the Buddhist Tzu Chi Medical Foundation","award":["TCMF-SP-108-01"],"award-info":[{"award-number":["TCMF-SP-108-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Purpose: To investigate the long-term satisfaction and complications in chronic spinal cord injury (SCI) patients after various bladder management strategies and surgical procedures for the treatment of urinary incontinence. Methods: Patients at a single institution with chronic SCI who received bladder management treatment or surgical procedure to improve urinary continence were retrospectively assessed. Thorough urological examinations and videourodynamic studies were performed. Patients were treated either through conservative approaches including medical treatment, clean intermittent catheterization (CIC), cystostomy, and indwelling urethral catheter, or through surgical procedures including detrusor botulinum toxin (Botox) injections, augmentation, ileal conduit, Kock pouch diversion, continent cystostomy, suburethral sling, and artificial urethral sphincter (AUS) implantation. The patients\u2019 satisfaction with urinary continence improvement, causes of dissatisfaction, long-term complications, and overall satisfaction with bladder and voiding condition were assessed. Results: A total of 700 consecutive patients were enrolled in this study. High satisfaction rates were noted after detrusor Botox injection (81.1%), augmentation enterocystoplasty (91.4%), autoaugmentation (80%), Kock pouch diversion, and continent cystostomy (all 100%). Fair satisfaction rates were noted after ileal conduit diversion (66.7%), suburethral sling (64.3%), and AUS implantation (66.7%). Patients who received conservative treatment with medicines, CIC, cystostomy, or an indwelling urethral catheter all had less-satisfactory outcomes (all &lt; 40%). Conclusion: Overall satisfaction with surgical procedures aimed to improve urinary continence in chronic SCI patients was higher than with conservative bladder management (35.4%). Appropriate surgical procedures for chronic SCI patients with neurogenic lower urinary tract dysfunction (NLUTD) and urological complications yielded satisfaction with both urinary continence improvement and with overall bladder and voiding condition.<\/jats:p>","DOI":"10.3390\/jcm11195864","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T23:39:31Z","timestamp":1665272371000},"page":"5864","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Satisfaction with Urinary Incontinence Treatments in Patients with Chronic Spinal Cord Injury"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1761-1185","authenticated-orcid":false,"given":"Sheng-Fu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Buddhist Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9325-9868","authenticated-orcid":false,"given":"Yu Khun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Buddhist Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7165-4771","authenticated-orcid":false,"given":"Hann-Chorng","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Buddhist Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1111\/j.1464-410X.2006.06395.x","article-title":"The management of neurogenic bladder and quality of life in spinal cord injury","volume":"98","author":"Ku","year":"2006","journal-title":"BJU Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.juro.2010.03.008","article-title":"Bladder management after spinal cord injury in the United States 1972 to 2005","volume":"184","author":"Cameron","year":"2010","journal-title":"J. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1080\/10790268.2008.11760737","article-title":"Early acute management in adults with spinal cord injury: A clinical practice guideline for health-care providers. Who should read it?","volume":"31","author":"Wing","year":"2008","journal-title":"J. Spinal Cord Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/S0090-4295(00)00761-5","article-title":"Clinical significance of detrusor sphincter dyssynergia type in patients with post-traumatic spinal cord injury","volume":"56","author":"Weld","year":"2000","journal-title":"Urology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/j.apmr.2008.10.023","article-title":"Transperineal injection of botulinum toxin A for treatment of detrusor sphincter dyssynergia: Localization with combined fluoroscopic and electromyographic guidance","volume":"90","author":"Tsai","year":"2009","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1016\/S0022-5347(05)67013-9","article-title":"Influences on renal function in chronic spinal cord injured patients","volume":"164","author":"Weld","year":"2000","journal-title":"J. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1111\/luts.12434","article-title":"Interventional management and surgery of neurogenic lower urinary tract dysfunction in patients with chronic spinal cord injury: A urologist\u2019s perspective","volume":"14","author":"Chen","year":"2022","journal-title":"Low Urin. Tract. Symptoms"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.eururo.2015.07.071","article-title":"Summary of European Association of Urology (EAU) Guidelines on Neuro-Urology","volume":"69","author":"Groen","year":"2016","journal-title":"Eur. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/00042307-199907000-00005","article-title":"Neurogenic bladder dysfunction","volume":"9","author":"Madersbacher","year":"1999","journal-title":"Curr. Opin. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1038\/sj.sc.3101312","article-title":"Intermittent catheterization: Which is the optimal technique?","volume":"40","author":"Wyndaele","year":"2002","journal-title":"Spinal Cord"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1038\/sj.sc.3101160","article-title":"Conservative treatment of the neuropathic bladder in spinal cord injured patients","volume":"39","author":"Wyndaele","year":"2001","journal-title":"Spinal Cord"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1038\/nrurol.2016.206","article-title":"The management of neurogenic lower urinary tract dysfunction after spinal cord injury","volume":"13","author":"Wyndaele","year":"2016","journal-title":"Nat. Rev. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1159\/000020320","article-title":"Is suprapubic cystostomy an optimal urinary management in high quadriplegics?. A comparative study of suprapubic cystostomy and clean intermittent catheterization","volume":"38","author":"Mitsui","year":"2000","journal-title":"Eur. Urol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1179\/2045772315Y.0000000056","article-title":"Bladder-emptying methods, neurogenic lower urinary tract dysfunction and impact on quality of life in people with long-term spinal cord injury","volume":"40","author":"Adriaansen","year":"2017","journal-title":"J. Spinal Cord Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.tcmj.2013.09.010","article-title":"Bladder management and urological complications in chronic spinal cord Injured patients in Taiwan","volume":"26","author":"Chen","year":"2014","journal-title":"Tzu. Chi. Med. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/S1474-4422(15)00070-8","article-title":"Lower urinary tract dysfunction in the neurological patient: Clinical assessment and management","volume":"14","author":"Panicker","year":"2015","journal-title":"Lancet Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.eururo.2009.04.028","article-title":"EAU guidelines on neurogenic lower urinary tract dysfunction","volume":"56","author":"Blok","year":"2009","journal-title":"Eur. Urol."},{"key":"ref_18","first-page":"470","article-title":"A UK consensus on the management of the bladder in multiple sclerosis","volume":"80","author":"Fowler","year":"2009","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1007\/s11255-013-0625-6","article-title":"Complication rate of neurogenic lower urinary tract dysfunction after spinal cord injury in Taiwan","volume":"46","author":"Lai","year":"2014","journal-title":"Int. Urol. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/S0022-5347(01)66376-6","article-title":"Botulinum-A toxin as a treatment of detrusor-sphincter dyssynergia: A prospective study in 24 spinal cord injury patients","volume":"155","author":"Schurch","year":"1996","journal-title":"J. Urol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.eururo.2003.12.004","article-title":"European experience of 200 cases treated with botulinum-A toxin injections into the detrusor muscle for urinary incontinence due to neurogenic detrusor overactivity","volume":"45","author":"Reitz","year":"2004","journal-title":"Eur. Urol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1111\/j.1464-410X.2009.08466.x","article-title":"Comparing two types of botulinum-A toxin detrusor injections in patients with severe neurogenic detrusor overactivity: A case-control study","volume":"104","author":"Grosse","year":"2009","journal-title":"BJU Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.1016\/j.juro.2011.02.004","article-title":"Efficacy of botulinum toxin A injection for neurogenic detrusor overactivity and urinary incontinence: A randomized, double-blind trial","volume":"185","author":"Herschorn","year":"2011","journal-title":"Urology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"301","DOI":"10.5213\/inj.2040354.177","article-title":"Frontiers in the clinical applications of botulinum toxin A as treatment for neurogenic lower urinary tract dysfunction","volume":"24","author":"Jiang","year":"2020","journal-title":"Int. Neurourol. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.eururo.2004.11.009","article-title":"Success of repeat detrusor injections of botulinum a toxin in patients with severe neurogenic detrusor overactivity and incontinence","volume":"47","author":"Grosse","year":"2005","journal-title":"Eur. Urol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.jfma.2013.10.009","article-title":"Therapeutic outcome and patient adherence to repeated onabotulinum toxin A detrusor injections in chronic spinal cord-injured patients and neurogenic detrusor overactivity","volume":"114","author":"Chen","year":"2015","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S0929-6646(09)60095-4","article-title":"Long-term outcomes of augmentation enterocystoplasty with an ileal segment in patients with spinal cord injury","volume":"108","author":"Chen","year":"2009","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1038\/sj.sc.3100441","article-title":"Bladder autoaugmentation in adult patients with neurogenic voiding dysfunction","volume":"35","author":"Kramer","year":"1997","journal-title":"Spinal Cord"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"133","DOI":"10.5213\/inj.1732708.354","article-title":"Long-term outcomes of augmentation enterocystoplasty in patients with end-stage bladder diseases: A single-institute experience involving 102 patients","volume":"21","author":"Wu","year":"2017","journal-title":"Int. Neurourol. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1038\/sc.2016.49","article-title":"Botulinum toxin therapy for neurogenic detrusor hyperactivity versus augmentation enterocystoplasty: Impact on the quality of life of patients with SCI","volume":"54","author":"Anquetil","year":"2016","journal-title":"Spinal Cord"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2184","DOI":"10.1097\/01.ju.0000061761.24504.47","article-title":"Continent lower urinary tract reconstruction in the cervical spinal cord injured population","volume":"169","author":"Zommick","year":"2003","journal-title":"J. Urol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/iju.14186","article-title":"Clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury","volume":"27","author":"Sekido","year":"2020","journal-title":"Int. J. Urol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/19\/5864\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:46:13Z","timestamp":1760143573000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/19\/5864"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,4]]},"references-count":32,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["jcm11195864"],"URL":"https:\/\/doi.org\/10.3390\/jcm11195864","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,4]]}}}