Clinical Urodynamic Evaluation of Urinary Disorders in Children With Cerebral Palsy Without Intellectual Deficit

Iranian Journal of Kidney Diseases

Volume 5 - Number Suppl.1

Article Type: Original Article
Abstract: Introduction. Approximately one third of children with cerebral palsy are expected to present with dysfunctional voiding symptoms. Lower urinary tract symptoms and related urodynamic findings in this group of patients have been documented in a limited number of published studies. The aim of this study was evaluation of voiding disorders and uroflowmetery pattern in these patients. Methods. This research was a clinical and paraclinical (urine analysis and culture, ultrasound and urodynamic) evaluation of urinary disorders in children (5 years old or more) with cerebral palsy without intellectual deficit who were referred to Ghaem and Sheikh Hospitals from December 2005 to October 2006. 40 children with cerebral palsy (18 were girl and 22 were boy) were examined for urine analysis and culture, after a history and physical examination. They underwent ultrasound examination of the kidney, ureter and bladder (for renal anomalies, bladder capacity and shape residual volume) and uroflowmetery. Result. 21 (52.2%) out of 40 patients, had dysfunctional voiding symptoms, that enuresis (20%) and frequency (20%) were the most common symptoms .The bladder thickening (37.5%) was the most common finding in ultrasound study. 16 (40%) patients showed normal pattern of urodynamics and 24 (70%) of children had abnormal urodynamic studies. Detresure sphincter dyssynergic pattern was presented in 10 (25%) as the most common urodynamic finding. Conclusion. the present study concludes that voiding dysfunction in children with cerebral palsy is more common than general population, which is similar to results from other published studies. So, we suggest that a rational plan of management of these patients depends on the evaluation of the lower urinary tract dysfunction with urine analysis and culture and urodynamic studies. These children benefit from earlier assessment and treatment.