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Clinical and urodynamic spectrum of bladder function in cerebral palsy.
J Urol. 2009 Oct; 182(4 Suppl):1945-8.JU

Abstract

PURPOSE

The nature of voiding function and dysfunction associated with cerebral palsy is described in the literature without concurrence of opinion. We correlated urodynamic findings with voiding patterns to better understand and manage voiding dysfunction in children with cerebral palsy.

MATERIALS AND METHODS

Voiding patterns and urodynamic studies in our last 31 patients with cerebral palsy were reviewed. Patients and families were surveyed on the child ability to void spontaneously, clean intermittent catheterization requirement, daytime incontinence and enuresis. Urodynamics consisted of slow fill water cystometry and patch electromyography. Measured parameters were bladder capacity based on age, capacity pressure, compliance, uninhibited contractions, bladder sensation and external sphincter activity. Patients were stratified by voiding status and statistical analysis was performed with p <0.05 considered significant.

RESULTS

The 15 boys and 16 girls were 4.5 to 16.6 years old. Three children required clean intermittent catheterization for bladder drainage and 28 (90.3%) voided spontaneously. Diapers were worn by 24 patients (77.4%). There were daytime incontinence and enuresis in 12 patients (38.7%), daytime incontinence only in 11 (35.5%) and enuresis in 1 (3.2%). Seven patients (22.6%) were continent day and night. When correlated with urodynamic parameters, continent children tended to have a larger bladder, lower bladder capacity pressure, higher compliance, fewer uninhibited contractions and similar sphincter activity. The only statistically significant difference was in bladder sensation.

CONCLUSIONS

There is a spectrum of clinical and urodynamic bladder function in children with cerebral palsy. Of these children 77.4% void spontaneously but are incontinent. Incontinence is more likely present during the day and rarely limited to enuresis. Urodynamically continent children have a similar storage profile and differ from children with daytime or nocturnal incontinence in the ability to sense bladder fullness.

Authors+Show Affiliations

Division of Pediatric Urology, Schneider Children's Hospital, North Shore-Long Island Jewish Health System, New Hyde Park, New York, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19695619

Citation

Richardson, Ingride, and Lane S. Palmer. "Clinical and Urodynamic Spectrum of Bladder Function in Cerebral Palsy." The Journal of Urology, vol. 182, no. 4 Suppl, 2009, pp. 1945-8.
Richardson I, Palmer LS. Clinical and urodynamic spectrum of bladder function in cerebral palsy. J Urol. 2009;182(4 Suppl):1945-8.
Richardson, I., & Palmer, L. S. (2009). Clinical and urodynamic spectrum of bladder function in cerebral palsy. The Journal of Urology, 182(4 Suppl), 1945-8. https://doi.org/10.1016/j.juro.2009.04.081
Richardson I, Palmer LS. Clinical and Urodynamic Spectrum of Bladder Function in Cerebral Palsy. J Urol. 2009;182(4 Suppl):1945-8. PubMed PMID: 19695619.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and urodynamic spectrum of bladder function in cerebral palsy. AU - Richardson,Ingride, AU - Palmer,Lane S, Y1 - 2009/08/20/ PY - 2008/12/03/received PY - 2009/8/22/entrez PY - 2009/8/22/pubmed PY - 2009/10/30/medline SP - 1945 EP - 8 JF - The Journal of urology JO - J Urol VL - 182 IS - 4 Suppl N2 - PURPOSE: The nature of voiding function and dysfunction associated with cerebral palsy is described in the literature without concurrence of opinion. We correlated urodynamic findings with voiding patterns to better understand and manage voiding dysfunction in children with cerebral palsy. MATERIALS AND METHODS: Voiding patterns and urodynamic studies in our last 31 patients with cerebral palsy were reviewed. Patients and families were surveyed on the child ability to void spontaneously, clean intermittent catheterization requirement, daytime incontinence and enuresis. Urodynamics consisted of slow fill water cystometry and patch electromyography. Measured parameters were bladder capacity based on age, capacity pressure, compliance, uninhibited contractions, bladder sensation and external sphincter activity. Patients were stratified by voiding status and statistical analysis was performed with p <0.05 considered significant. RESULTS: The 15 boys and 16 girls were 4.5 to 16.6 years old. Three children required clean intermittent catheterization for bladder drainage and 28 (90.3%) voided spontaneously. Diapers were worn by 24 patients (77.4%). There were daytime incontinence and enuresis in 12 patients (38.7%), daytime incontinence only in 11 (35.5%) and enuresis in 1 (3.2%). Seven patients (22.6%) were continent day and night. When correlated with urodynamic parameters, continent children tended to have a larger bladder, lower bladder capacity pressure, higher compliance, fewer uninhibited contractions and similar sphincter activity. The only statistically significant difference was in bladder sensation. CONCLUSIONS: There is a spectrum of clinical and urodynamic bladder function in children with cerebral palsy. Of these children 77.4% void spontaneously but are incontinent. Incontinence is more likely present during the day and rarely limited to enuresis. Urodynamically continent children have a similar storage profile and differ from children with daytime or nocturnal incontinence in the ability to sense bladder fullness. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/19695619/Clinical_and_urodynamic_spectrum_of_bladder_function_in_cerebral_palsy_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2009.04.081?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -