• Benign Prostatic Hyperplasia
  • Hormone Therapy
  • Genomic Testing
  • Next-Generation Imaging
  • UTUC
  • OAB and Incontinence
  • Genitourinary Cancers
  • Kidney Cancer
  • Men's Health
  • Pediatrics
  • Female Urology
  • Sexual Dysfunction
  • Kidney Stones
  • Urologic Surgery
  • Bladder Cancer
  • Benign Conditions
  • Prostate Cancer

Cerebral palsy incontinence likely due to underlying pathology


Video urodynamic studies found serious underlying pathology in a majority of cerebral palsy children who had urinary incontinence.

"Urinary incontinence is a very common finding in children with CP," said Andrew Combs, RPA-C, director of pediatric urodynamics at the Morgan Stanley Children's Hospital of New York Presbyterian. "The problem is that many clinicians rarely give it more than a cursory evaluation. Our patients with CP had more voiding pathology than expected, based on generally held beliefs."

In this small population, 18 patients (82%) had hyperreflexia and one (4.5%) had hypocontractility. Sixteen of the patients (73%) had signs of significant bladder or upper urinary tract insult. Problems included grades III to V reflux (27%) associated with urinary tract infection and detrusor-sphincter dyssynergia, diverticula (23%), severe loss of compliance (27%), renal failure (4.5%), and detrusor decompensation (14%). Only six (38%) of the patients had any previously identified bladder or renal injury.

"This paper says that a lot of us may not have completely evaluated children with disabilities," said Patrick McKenna, MD, professor and chair of urology at Southern Illinois University School of Medicine, Springfield. "Many of these children have treatable conditions. I have certainly begun to rethink the ways I manage more severely handicapped patients."

Dr. McKenna said that many physicians see impaired mentation, impaired movement, or other handicaps associated with neurologic disease and assume that physical problems such as incontinence cannot be treated because the patients do not have the mental maturity to participate in their care. This leads some clinicians to believe that further evaluation is unnecessary until the mental age reaches a certain level.

Related Videos
Miriam Harel, MD, answers questions during a Zoom video interview
Sleeping child | Image Credit: © Kenishirotie - stock.adobe.com
Miriam Harel, MD, answers a question during a Zoom video interview
Related Content
© 2024 MJH Life Sciences

All rights reserved.