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RESEARCH ARTICLE

Design and validation of a scale for neurogenic lower urinary tract dysfunction secondary to spinal cord injury

Shangzhen Geng1,2† ,  Rui Chen1† ,  Lipeng Chen1 ,  Guanghao Chen1 ,  Wenqiang Qi1 ,  Yaofeng Zhu1 ,  Wenfu Wang1 ,  Zhaocun Zhang1 ,  Fei Du1 ,  Wei Ji1 ,  Xige Ruan1 ,  Yunwei Li2 ,  Yanyan Zhang1* ,  Benkang Shi1* ,  Yan Li1*
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1 Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
2 Department of Urology, Shandong Provincial Third Hospital, Jinan, Shandong 250031, China
Bladder, e21200077 https://doi.org/10.14440/bladder.0296
Submitted: 14 September 2025 | Revised: 22 October 2025 | Accepted: 13 November 2025 | Published: 7 January 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Background: Spinal cord injury-induced neurogenic lower urinary tract dysfunction (SCI-NLUTD) tends to be accompanied by bowel dysfunction, sexual dysfunction, and psychological disorders. To date, a convenient and concise tool for the comprehensive assessment of these symptoms in patients with SCI-NLUTD has been lacking. Objective: This study aimed to design and evaluate a comprehensive patient-reported outcome measuring system for SCI-NLUTD patients to facilitate patient follow-up and treatment. Methods: A draft questionnaire was designed based on a review of the literature and input from patients and experts, and was refined using the Delphi method. The scale was administered to 185 patients with SCI-NLUTD. Reliability was assessed using Cronbach’s alpha and test–retest reliability coefficients, while validity was evaluated through exploratory factor analysis, and in terms of content validity index, content validity ratio, and kappa statistics. Results: The final SCI-NLUTD scale includes 7 domains, 23 items, and 1 item assessing urination pattern. It demonstrated good internal consistency (Cronbach’s alpha = 0.775) and test–retest reliability (0.731–0.998). Validity was confirmed (Kaiser–Meyer–Olkin = 0.784, content validity index ≥0.89, content validity ratio ≥0.78, and kappa statistics ≥0.89). Results were visualized using radar charts to facilitate clearer tracking of symptom profiles. Conclusion: The SCI-NLUTD scale is a reliable, valid, and convenient tool for comprehensive assessment of SCI-NLUTD symptoms, aiding in treatment planning and monitoring patients’ quality of life.

Keywords
Neurogenic lower urinary tract dysfunction
Spinal cord injury
Questionnaire design
Comprehensive assessment
Radar chart
Funding
This research was funded by a grant from the National Key Research and Development Program of China, Grant no. 2022YFC3602900; the Tai Shan Scholar Foundation and Clinical Research Project of Shandong University, Grant no. 2021SDUCRCC001; the National Natural Science Foundation of China, Grant no. 81900637; Clinical Research Project of Shandong University, Grant nos. 2020SDUCRCC021; the National Natural Science Foundation of China, Grant no.82200866, and Shandong Provincial Natural Science Foundation No. ZR2022QH129.
Conflict of interest
The authors declare they have no competing interests.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific
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