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.
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