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Bladder and bowel control in children with cerebral palsy: case-control study
Mustafa Ozturk1, Faruk Oktem, Nesimi Kisioglu
1Department of Public Health, Suleyman Demirel University School of Medicine, Isparta, Turkey. muozturk@med.sdu.edu.tr
Insights
Children with cerebral palsy achieve bladder and bowel control later than their peers. This population also experiences higher rates of enuresis and urinary tract infections, highlighting a need for targeted support.
Area of Science:
- Pediatric Rehabilitation
- Child Neurology
- Urology
Background:
- Cerebral palsy (CP) significantly impacts motor development, potentially affecting continence.
- Understanding the nuances of bladder and bowel control development in children with CP is crucial for early intervention and management.
Purpose of the Study:
- To investigate the age of bladder and bowel control development in children with cerebral palsy.
- To determine the prevalence of enuresis, encopresis, and urinary infections in this population compared to siblings and healthy children.
Main Methods:
- A comparative study involving 45 children with CP, 37 siblings, and 37 healthy children.
- Data collected via questionnaires on developmental milestones and urinary symptoms.
- Urinary samples analyzed for infection in a subset of participants.
Main Results:
- Children with CP achieved nighttime bladder and bowel control significantly later (mean ages 47 and 45 months, respectively) than siblings (35 and 26 months) and healthy controls (27 and 25 months).
- Constipation was notably more prevalent in children with CP (P<0.001).
- Urinary tract infections were more frequent in children with CP (P=0.024).
Conclusions:
- Children with cerebral palsy experience delayed bladder and bowel control development.
- This group exhibits increased incidence of enuresis and urinary infections, underscoring the need for specialized care and management strategies.
Aim:
To determine the age of development of bladder and bowel control and the frequency of enuresis, encopresis, and urinary infections in children with cerebral palsy.
Methods:
The study included 45 children with cerebral palsy who regularly attended a rehabilitation center in Isparta, Turkey, and two groups of age- and sex-matched children, 37 siblings of the children with cerebral palsy and 37 healthy children. Demographic data and information on the age of development of total bladder and bowel control and presence of possible urinary symptoms in children were collected from their caregivers by use of a questionnaire. Frequency of enuresis and encopresis was estimated among the children aged > or =5 years. A mid-way urinary sample was obtained from 40, 22, and 21 children in the cerebral palsy, siblings, and healthy children, respectively.
Results:
The mean age of nighttime bladder and bowel control development was 47 months (95% confidence interval [CI], 35-58) and 45 (36-55) months, respectively, for the children with cerebral palsy, 35 months (95% CI, 24-46) and 26 months (95% CI, 24-28), respectively, for their siblings, and 27 months (95% CI, 22-33) and 25 months (95% CI, 23-27) months, respectively, for the healthy children. Among the children aged > or =5 years, enuresis was present in 11 of 34 children with cerebral palsy, 7 of 30 siblings, and 4 of 30 healthy children (P = 0.200), whereas encopresis was present in 5 children with cerebral palsy, one sibling, and one healthy child. Constipation was significantly more present in chidlren with cerebral palsy than in other two groups (P<0.001). Urine culture was positive in 13 children with cerebral palsy, 1 sibling, and 2 healthy chidlren (P = 0.024). There were no significant differences in other urinary symptoms and laboratory findings among the three groups.
Conclusion:
The children with cerebral palsy gained bladder and bowel control at older age in comparison with their siblings and healthy children. They also had more frequent enuresis and urinary infections.
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