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J Spinal Cord Med. 2017 Sep;40(5):548-559. doi: 10.1080/10790268.2016.1213554. Epub 2016 Aug 31.

Impact of bladder, bowel and sexual dysfunction on health status of people with thoracolumbar spinal cord injuries living in the community.

Author information

a Rick Hansen Institute , Vancouver , BC , Canada.
b Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada.
c Urologic Sciences , University of British Columbia , Vancouver , BC , Canada.
d International Collaboration on Repair Discoveries (ICORD) , University of British Columbia , Vancouver , BC , Canada.
e Vancouver Sperm Retrieval Clinic, Vancouver Coastal Health Authority , Vancouver , BC , Canada.
f G.F. Strong Rehabilitation Center , Sexual Health Rehabilitation Service , Vancouver , BC , Canada.
g Division of Spine, Department of Orthopaedics , University of British Columbia , Vancouver , BC , Canada.
h Division of Neurology, Department of Medicine , University of British Columbia , Vancouver , BC , Canada.
i Vancouver Spine Surgery Institute , Vancouver General Hospital , Vancouver , BC , Canada.



The disruption of autonomic function following a spinal cord injury (SCI) is common and can negatively affect quality of life. The objective of this study was to describe the prevalence of bladder/bowel incontinence and sexual dysfunction in community-dwelling individuals with a thoracolumbar SCI and examine the impact on general physical and mental health status.


Participants who sustained a traumatic SCI to the thoracolumbar region of the spinal cord and classified as American Spinal Injury Association Impairment Scale (AIS) A to D were recruited. Demographic, injury data, MRI classification and neurological data were collected on admission. At follow-up, the neurological data, a questionnaire collecting participant-reported secondary health conditions (SHCs) (e.g. bladder incontinence, depression etc.) following SCI and health status measured by Short Form-36 were obtained. Regression models determined the association of health status with demographic/injury-related data, types and number of SHCs.


Of the 51 participants, 58.8% reported bladder incontinence, 54.0% bowel incontinence, 60.8% sexual dysfunction and 29.4% had all three. The regression models demonstrated that age at injury, bowel incontinence, sexual dysfunction, presence of pain, motor score at follow-up and the number of SHCs were significant predictors of health status. The number of SHCs was more predictive than all other demographic and injury variables for health status.


Results highlight the high prevalence of self-reported bowel/bladder incontinence and sexual dysfunction in the traumatic thoracolumbar SCI population and support the need for standardized assessments. Several demographic, injury-related and SHCs impacted health status and should be considered for the management of individuals living in the community.


Fecal incontinence; Quality of Life; Sexual dysfunction; Spinal cord injuries; Urinary incontinence

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