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Management of neurogenic bladder in patients with cerebral palsy
Ming-Hsien Wang1, Joyce Harvey, Laurence Baskin
1UCSF Children's Hospital, University of California, San Francisco, CA, USA.
Insights
Cerebral palsy (CP) is a brain injury affecting movement and coordination. Early identification and management of physical disabilities, including urologic issues, are crucial for children with CP to achieve near-normal adult lives.
Area of Science:
- Neurology
- Pediatrics
- Urology
Background:
- Cerebral palsy (CP) is a non-progressive brain injury impacting motor function due to perinatal anoxia.
- Risk factors include prematurity, low birth weight, perinatal infections, seizures, and intracranial hemorrhage.
- Clinical presentation varies, involving delayed motor development, altered muscle tone, and gait abnormalities.
Purpose of the Study:
- To review the urologic evaluation and management of patients with cerebral palsy.
- To briefly discuss normal bladder physiology and voiding patterns in the context of CP.
Main Methods:
- Literature review focusing on urologic aspects of cerebral palsy.
- Discussion of clinical presentations and management strategies.
- Inclusion of basic principles of bladder function.
Main Results:
- Cerebral palsy significantly impacts motor control, leading to diverse physical impairments.
- Supportive care and proper management enable many individuals with CP to lead fulfilling adult lives.
- Urologic issues are common and require specific evaluation and management.
Conclusions:
- Comprehensive management of physical disabilities, including urologic concerns, is essential for individuals with cerebral palsy.
- Understanding bladder physiology is key to addressing urologic complications in CP.
- Early and appropriate interventions improve long-term outcomes for children with CP.
Abstract:
Cerebral palsy (CP) is a non-progressive injury of the brain that affects muscle movement and coordination secondary to anoxia that occurred during the perinatal period. Babies who are premature, low birth weight, and those who sustained perinatal infection, seizure, or intracranial hemorrhage are at an increase risk of being affected. The injury mainly involves the motor control center of the brain; therefore, presents clinically with variable physical impairments, ranging from delayed gross or fine motor development to altered muscle tone and gait. With public awareness and research, the full spectrum of intelligence and capabilities of these children is now being appreciated. Studies have shown that with supportive caretakers, many of these children go on to enjoy near-normal adult lives. Therefore, it is imperative that their physical disabilities are identified and managed properly. In this review, we will focus primarily on urologic evaluation and management of patients with CP, with a brief review of normal bladder physiology and voiding pattern.
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