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Spina Bifida, continence et qualité de vie : étude multicentrique

Abstract : Quality of life is increasingly seen as a key out come in determining the success of rehabilitation programmes. Bowel and bladder incontinence is frequently encountered in patients with Spina Bifida (SB). We have assumed that incontinence control, achieved through rigorous medical or surgical management, may lead to better health related quality of life (HRQoL). It was hypothesized that better continence might predict better HRQoL in people with SB. ln a multicenter study, urinary and faecal continence was assessed and urological and intestinal management was retrospectively reviewed. HRQoL in adult patients was assessed using the MOS-SF36 (Medical Outcome Study-Short Form). HRQoL in adolescents was scored using the VSP (Vécu Santé Perçu). Univariate and multivariate analysis were used to examine the relationships between sex, age, walking ability, urinary/faecal continence, methods of urinary/faecal management and HRQoL. Interviews were conducted in 460 patients. 300 were adults (mean age at 27.1 ± 6.9 years) and 160 were adolescents (mean age at 14.4 ± 1.8 years). ln 55% of patients, bladder management was based on surgical treatments. Surgical techniques providing better urinary continence were detailed. Treatment of faecal incontinence was mainly conservative. Malone's procedure was performed in 9.7% of patients. The present study failed to demonstrate strong relationships between continence, treatments, and HRQoL in patients with SB. A prospective survey of HRQoL, particularly before and after an operation, is essential if we are to determine the effects of various continence management strategies on HRQoL among people with SB.
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Jean-Louis Lemelle. Spina Bifida, continence et qualité de vie : étude multicentrique. Médecine humaine et pathologie. Université Henri Poincaré - Nancy 1, 2006. Français. ⟨NNT : 2006NAN10242⟩. ⟨tel-01746996⟩



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