Related Experiment Videos
Development of bladder control in children and adolescents with cerebral palsy
L E Roijen1, K Postema, V J Limbeek
1St Maartenskliniek, Nijmegen, The Netherlands. Ruroijen@wxs.nl
Insights
Children with cerebral palsy (CP) often experience delayed bladder control development. Factors like tetraplegia and low intellectual capacity increase the risk of urinary incontinence in these children.
Area of Science:
- Pediatric Rehabilitation
- Neurodevelopmental Disorders
- Urology
Background:
- Cerebral palsy (CP) affects motor function and can impact other developmental milestones.
- Urinary incontinence is a common challenge for children with CP, affecting their quality of life.
- Understanding bladder control development in CP is crucial for targeted interventions.
Purpose of the Study:
- To investigate bladder control development in children and adolescents with CP.
- To identify subgroups with delayed bladder control and higher risk of incontinence.
- To determine factors associated with achieving urinary continence.
Main Methods:
- Cross-sectional study involving 601 children and adolescents (4-18 years) with CP from Dutch rehabilitation centers.
- Parental questionnaire assessing urinary incontinence and developmental milestones.
- Survival curve analysis to model the development of bladder control.
Main Results:
- Prevalence of primary urinary incontinence was 23.5% in the study cohort.
- Bladder control development was significantly delayed in children with CP compared to typically developing peers.
- Tetraplegia and low intellectual capacity were key factors associated with persistent urinary incontinence.
- At age six, spontaneous continence was achieved by 54% with spastic tetraplegia and 80% with spastic hemiplegia/diplegia.
- Only 38% of children with low intellectual capacity achieved dryness by age six.
Conclusions:
- Children with CP exhibit delayed urinary continence development.
- Specific CP subtypes (tetraplegia) and cognitive impairment are significant risk factors for incontinence.
- Early identification of these risk factors is essential for timely intervention and support.
Abstract:
The study aimed to investigate the development of bladder control in children with cerebral palsy (CP) and to determinate subgroups with deviant development of bladder control and a higher risk of not achieving urinary continence. Children and adolescents between the ages of 4 and 18 years with a diagnosis of CP, from six Dutch rehabilitation centres were included in the study (n=601). Parents of these participants were sent a questionnaire, of whom 76% responded. Prevalence of primary urinary incontinence was 23.5%. Survival curves were made to determine the development of achieving bladder control in CP. For participants who achieved urinary continence, the development was delayed in comparison with normally developing children and adolescents. The most important factors influencing the occurrence of urinary incontinence in CP were tetraplegia and low intellectual capacity. At age six, 54% of participants with spastic tetraplegia and 80% with spastic hemiplegia or diplegia gained urinary continence spontaneously. Of those who had low intellectual capacity, 38% were dry at this age.