Urinary disorders in children with cerebral palsy sequelae

Dr Olfa KHARRATa, Dr Amira YAHYAOUIa, Mrs Wafa AMEYRIb, Prof Fatma Zahra BEN SALAHa, Prof Catherine DZIRIa

a Institut national d'Orthopédie Kassab, b Association générale des insuffisants moteurs

INTRODUCTION: Cerebral palsy is the cause of psychomotor retardation but its consequences are not confined to motor's acquisitions. The objective of this work is to determine the type of urinary symptoms and their repercussions on the urinary tract in children with cerebral palsy

Patients and methods : Prospective study initially conducted at the general Association of Persons with Motor Deficiencies (AGIM) of Tunisia, having focused on patients monitored for cerebral palsy sequelae in the year 2014. After having the informed consent of the parents, the evaluation involved meticulous neuro-orthopedic and neurological clinical examinations. We used the Gross Motor Function Classification System scale for Cerebral Palsy (GMFCS) to assess the functional abilities of the child. We completed at our institute additional tests if the presence of urinary disorders.
Results: Fifty-nine children were included (37 boys). The mean age was 7.05 years. The clinical presentation was spastic tetraparesis in 81% of children and spastic hemiparesis in 15%. The march was possible in 46% of patients. Cleanliness was obtained in 62.5%. The rest was carrying layers without the parents were concerned. Urinary symptoms were present in 60% of patients, type of urinary incontinence in 47%, enuresis in 70%, dysuria in 10%. Urinary ultrasound exam was normal in the majority of patients. Urodynamic Exploration has confirmed disorders of continence and evacuation.

CONCLUSION: Urinary problems are common in children with cerebral palsy. This is consistent with the literature. What needs to be considered in the care of these children and educated parents.

References :

1.Silva JA et al. Lower urinary tract dysfunction in children with cerebral palsy. Neurourology and Urodynamics 2009;28: 959-63.

2.Gundogdu G et al .Relationship of bladder dysfunction with upper urinary tract deterioration in cerebral palsy. Journal of Pediatric Urology 2013;9: 659-64.

3. Murphy K. Cerebral palsy, neurogenic bladder, and outcomes of lifetime care. Developmental Medicine & Child Neurology 2012;54: 945-50.

Keywords : cerebral palsy, urinary disorders, evaluation