The aim of our study was to examine sex-specific differences in bladder-related quality of life in persons with neurogenic lower urinary tract dysfunction (NLUTD).

Starting in September 2024, the Qualiveen Short-Form (SF) Questionnaire, a validated instrument for assessing bladder-related quality of life in individuals with NLUTD, was administered to patients at a specialized acute care and rehabilitation center for spinal cord injury who underwent urodynamic examination. The questionnaires returned from September 2025 to January 2026 (5 months) as well as the collected routine clinical data (e.g., sex, age, bladder voiding method, urinary continence, urodynamic parameters, medication) were analyzed. Treatment success and whether the upper urinary tract was at risk were assessed based on urodynamic measurements. Regression analysis was used to evaluate the effects of sex, age, voiding method, urinary continence, urinary tract infections, and treatment success on quality of life.

We analyzed data from 113 of 358 (31.6%) individuals with NLUTD (48 females and 65 males) who returned the questionnaire. The mean age of females was 60.9±12.4 years and 54.9±16.9 years for the males (p=0.04). The average duration of NLUTD was 21.8 ± 15.1 years for females and 22.1 ± 16.9 years for males (p=0.9). There was no significant (p > 0.5) difference regarding treatment success (females: 77.1% vs. males: 76.9%) and occurrence of upper urinary tract risk (females: 8.3% vs. males: 12.3%) between the sexes. 

There were no significant (p > 0.12) sex-specific differences in the Qualiveen SF total score or in any of the subscales. The overall median total score was 1.1 (quartiles 0.6 / 1.8). The greatest median score was observed in the category “frequency limitations” (median 1.5, quartiles 1.0 / 2.5). Individuals with urinary incontinence had a significantly (p = 0.037) greater total score (median 1.75, quartiles 1.125 / 2.125). Females were significantly (p = 0.0001) more often affected by urinary incontinence (58.3%) compared to males (22.0%). Age, voiding method, urinary tract infections, and treatment success had no significant (p > 0.15) effect on quality of life.

In this study population of individuals with well-managed NLUTD based on urodynamic parameters, no sex-specific differences in bladder-related quality of life were observed. The overall median total score indicates that NLUTD has a small impact on quality of life in the evaluated individuals. Age, voiding method, urinary tract infections, and treatment success showed no significant impact on quality of life. In contrast, urinary incontinence was associated with a significantly greater burden. However, females maintained a quality of life comparable to males, despite higher rates of urinary incontinence.

The results underscore the value of individually tailored management of NLUTD but indicate that the management of urinary incontinence should be a particular focus.