Cerebral palsy, neurogenic bladder, and outcomes of lifetime care

Abstract

Aim To determine the prevalence of symptomatic neurogenic bladder (SNB) and social and functional variables in a large sample of people with cerebral palsy (CP). Method The medical records of 214 individuals (96 females, 118 males) with CP between the years 1990 and 2000 were retrospectively reviewed. Individuals with frequency, urgency, or incontinence were assigned Gross Motor Function Classification System levels and underwent cystometrogram/electromyelogram studies. Neurogenic bladders were classified according to the nomenclature of the International Continence Society. Results Fifty-two patients had hemiplegia, 42 diplegia, 117 quadriplegia, and three dyskinesia. Educational levels ranged from full special education to those with graduate degrees. Thirty-five individuals in our group aged 5 to 66years had SNB with a prevalence of 16.4%. The median age for the entire population was 9years 7months and for those with SNB 12years 4months (range 5-57y). Over 80% of individuals who underwent investigation were found to have spastic hyper-reflexic type bladders. Ninety-one percent obtained total continence or major improvement with conservative care. SNB was documented across the lifespan, educational spectrum, and functional level. Upper urinary tract pathology was infrequent. Interpretation SNB is a common finding in individuals with CP. In most patients it is readily diagnosed and treated with conservative interventions. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.