Development of a questionnaire dedicated to neurogenic lower urinary tract dysfunction and localization- a pilot study

Abstract

Background & Objective: There is a significant knowledge gap and paucity of symptom questionnaires to assess neurogenic lower urinary tract dysfunction (NLUTD). This study aimed to localize the level, nature and severity of NLUTD using a self-made set of questions that can be used to evolve a NLUTD specific questionnaire.

Methods: This cross-sectional, observational single centre pilot study included patients with non-obstructive NLUTD. Based on inputs from literature, experts and patients, a set of questions was generated, henceforth called the AIIMS-J NLUTD questionnaire (AIIMS-J NUDQ). The expected clinical type and level of bladder involvement was classified into frontal, suprapontine, suprasacral infrapontine and sacral or infra-sacral lesions. The answers on the AIIMS-J NUDQ were noted for each level of bladder involvement to delineate localization specific questions and evolve a diagnostic algorithm for neurogenic bladder.

Results: The AIIMS-J NUDQ had two different sets of questions. The first set had responses in the form of yes and no while the second set focused on quantification of symptoms. In the pilot study of 72 patients, bladder involvement was localised to frontal level in 11.1%, suprapontine (34.7%), suprasacral (37.5%), sacral/infra-sacral (9.7%) and UMN bladder with shock (7.0%). Specific features were observed in the different bladder types. Ten discriminatory questions were defined to aid localization of NLUTD and a diagnostic algorithm formulated.

Conclusions: Analysis of bladder dysfunction in neurological disorders using the AIIMS-J NUDQ demonstrated it was able to espouse specific bladder related symptoms that could help in localization of NLUTD.