2008 Annual Meeting Abstracts

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Characterization of Urinary Incontinence in Patients with Normal Pressure Hydrocephalus (NPH)
Adam P Klausner, Clinton W Collins, Sonia Bahlani*, Blake G Moore*, Anthony Marmarou*, Harold F Young*, Luke G Wolfe*, Harry P Koo
Virginia Commonwealth University Health System, Richmond, VA

Introduction:
NPH is a chronic neurologic condition affecting geriatric patients. It is characterized by cognitive impairment, gait disturbances, and incontinence. Currently, it is not possible to predict improvement in lower urinary tract symptoms (LUTS) after ventriculo-peritoneal (VP) shunting. The purpose of this investigation was to characterize the type, severity, and quality-of-life impact of urinary incontinence in patients with NPH.
Methods:
Patients with NPH evaluated in a specialized neurosurgery clinic were administered validated surveys to assess for incontinence (ICIq-UI short form: scored 0-21), overactive bladder (ICIq-OAB, 4 questions, each scored 0-4) quality-of-life impact from lower urinary tract symptoms (ICIq-LUTSqol, scored 0-10), and the AUA symptom index bother score (scored 0-6). Data are presented a means ± SEM.
Results:
Seventy-two patients with NPH completed all 4 surveys of which 35/72 (48.6%) were unshunted and 37/72 (51.4%) had been treated with VP shunts. ICIq-UI short form score was 9.42 ± 2.32. ICIq-OAB daytime frequency score was 0.82 ± 1.04, nighttime frequency score was 1.75 ± 1.13, urinary urgency score was 1.74 ± 1.08, and urinary incontinence score was 1.57 ± 1.02. Quality-of-life related to LUTS (ICIq-LUTSqol score) was 3.7 ± 1.73 and AUA-SI bother score was 3.39 ± 1.02.
Conclusions:
This is the first study to establish the type, severity, and quality-of-life impact of LUTS related to NPH using validate survey instruments. With further research, it may be possible to identify factors that predict favorable responses to VP shunting.

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