J Clin Neurol.  2013 Jul;9(3):144-150. 10.3988/jcn.2013.9.3.144.

Guillain-Barre Syndrome: Prevalence and Long-Term Factors Impacting Bladder Function in an Australian Community Cohort

Affiliations
  • 1Department of Rehabilitation Medicine, Royal Melbourne Hospital, Victoria, Australia. bhasker.amatya@mh.org.au
  • 2Department of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia.
  • 3School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
  • 4Royal Park Continence Service, Royal Melbourne Hospital, Victoria, Australia.
  • 5Rural Health Academic Centre, University of Melbourne, Victoria, Australia.

Abstract

BACKGROUND AND PURPOSE
Urinary dysfunction is associated with significant morbidity in persons with Guillain-Barre Syndrome (GBS). The aim of this study was to describe prevalence and long-term impact of bladder dysfunction on daily activities and quality of life (QoL) in persons in chronic phase of GBS and to examine the relationships between commonly used continence measures in this cohort.
METHODS
Prospective cohort (n=66) following GBS treatment (1996-2009) was recruited from a tertiary hospital and assessed using standardised measures for bladder dysfunction: American Urological Association (AUA) Symptom Index, Incontinence Impact Questionnaire, Urogenital Distress Inventory.
RESULTS
Sixty-six participants (64% male, mean age 56 years, median disease duration of 6.1 years) completed the study. Of these more than half reported nocturia and one-third reported urinary urgency and frequency. Urinary problems impacted on participants' daily activities: physical recreation (21%), emotional health and mood (17%), entertainment (14%), participation and mobility (>30 min) (12%), and performance of household chores (8%). Since GBS, 49% reported interference of urinary symptoms with daily life to some extent; and adverse impact on QoL (10.6%). Significant relationship between bladder symptoms; and the level of urogenital distress (p<0.001) and the impact of urinary problems (p<0.001), was noted. Higher scores on the bladder scales showed significant correlations with psychological, functional and participation scales. The single QoL item (AUA scale) correlated significantly with all other bladder scales (rho=0.63-0.86). This can be a potential 'screening tool' to identify patients for further assessment.
CONCLUSIONS
Bladder dysfunction in chronic phase of GBS is not well studied. More research in longer-term screening and outcomes for bladder intervention are needed for integrated care and to guide treating clinicians.

Keyword

Guillain-Barre Syndrome; rehabilitation; urinary tract; disability; participation

MeSH Terms

Cohort Studies
Family Characteristics
Guillain-Barre Syndrome
Humans
Male
Mass Screening
Nocturia
Prevalence
Prospective Studies
Quality of Life
Recreation
Tertiary Care Centers
Urinary Bladder
Urinary Tract
Weights and Measures
Surveys and Questionnaires

Figure

  • Fig. 1 Flow chart of recruitment process. GBS: Guillain-Barré Syndrome, MH: Melbourne Health, RMH: Royal Melbourne Hospital.


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