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Neurogenic Bladder Symptom Score (NBSS)

The NBSS was designed as an objective and validated way to assess bladder symptoms in patients with neurogenic bladder dysfunction as a result of spinal cord injury, multiple sclerosis, and spinal bifida. (1,2) The objective of this instrument is to measure symptoms, not to assign relative value to them, or to judge how they impact the patients’ quality of life. This is analogous to using the IPSS/AUA-SS to measure urinary symptoms in BPH. The final question of the NBSS asks about the person’s urinary quality of life.

The NBSS consists of 24 questions. The first question classifies patients by bladder management, but does not make up part of the numeric score. The remaining questions address 3 domains: incontinence, storage and voiding, and consequences. The final question is an overall quality of life question. The total score can range from 0 (no symptoms at all) to 74 (maximum symptoms). The median time to complete the NBSS is 6 minutes. The NBSS has been validated in a second data set consisting of only SCI patients(3), and has demonstrated responsiveness(4). Validated translations into Brazilian Portuguese (5), Italian(6), and Russian(7) have been published. Other validated translations to French, Spanish, Polish, and Turkish are underway. An expert review panel suggested that the National Institute of Health (United States) consider the NBSS as a supplement measure in neurogenic bladder studies.(8)

The NBSS-SF was developed from the existing NBSS questions. It has demonstrated validity and reliability(9), but a smaller number of questions (fits on a single page). The first question classifies patients by bladder management, but does not make up part of the numeric score (similar to the NBSS), and then 8 questions cover the 3 domains of incontinence, storage and voiding, and consequences. The final question is the same overall quality of life question as in the full NBSS. The overall score performs well, however if you are interested in the subdomains as individual outcomes, the full NBSS is still likely a better choice.

There is no charge to use the NBSS or NBSS-SF for academic research, or personal clinical use. Please complete the short user agreement form and return to Dr Blayne Welk for permission to use the NBSS/NBSS-SF.

User Agreement Form

References

  1. Welk B, Morrow SA, Madarasz W, Potter P, Sequeira K. The conceptualization and development of a patient-reported neurogenic bladder symptom score. Res Rep Urol. 2013;5:129–37.
  2. Welk B, Morrow S, Madarasz W, Baverstock R, Macnab J, Sequeira K. The validity and reliability of the neurogenic bladder symptom score. J Urol. 2014 Aug;192(2):452–7.
  3. Welk B, Lenherr S, Elliott S, Stoffel J, Presson AP, Zhang C, et al. The Neurogenic Bladder Symptom Score (NBSS): a secondary assessment of its validity, reliability among people with a spinal cord injury. Spinal Cord. 4 ed. Nature Publishing Group; 2018 Mar;56(3):259–64.
  4. Welk B, Carlson K, Baverstock R. A pilot study of the responsiveness of the Neurogenic Bladder Symptom Score (NBSS). Can Urol Assoc J. 2017 Dec;11(12):376–8.
  5. Cintra LKL, de Bessa J, Kawahara VI, Ferreira TPA, Srougi M, Battistella LR, et al. Cross-cultural adaptation and validation of the neurogenic bladder symptom score questionnaire for Brazilian Portuguese. Int braz j urol. 2019 May 2;45.
  6. Fragalà E, Russo GI, Di Rosa A, Giardina R, Privitera S, Favilla V, et al. Association Between the Neurogenic Bladder Symptom Score and Urodynamic Examination in Multiple Sclerosis Patients With Lower Urinary Tract Dysfunction. Int Neurourol J. 2015 Dec;19(4):272–7.
  7. Philippova ES, Bazhenov IV, Volkova LI, Moskvina EY, Turova EL, Popova YV. [Russian version of the neurogenic bladder symptom score (NBSS)]. Urologiia. 2018 Dec;(6):5–13.
  8. Tate DG, Wheeler T, Lane GI, Forchheimer M, Anderson KD, Biering-Sørensen F, et al. Recommendations for evaluation of neurogenic bladder and bowel dysfunction after spinal cord injury and/or disease. J Spinal Cord Med. 2020 Mar;43(2):141–64.
  9. Welk B, Lenherr S, Elliott S, Stoffel J, Gomes CM, de Bessa J, et al. The creation and validation of a short form of the Neurogenic Bladder Symptom Score. Neurourol Urodyn. John Wiley & Sons, Ltd; 2020 Mar 20;35(1):8.