[Clinical evaluation for voiding dysfunction in patients with cerebral-palsy]

Urological assessments were done on 132 patients with cerebral palsy, ranging from 5 to 59 years in age (mean 23.2). Concerning urological symptoms, urinary incontinence, decreased urinary stream and urinary tract infection were at 31.8, 14.4 and 16.7%, respectively. Patients with functionally impaired ambulation had a high incidence of urinary incontinence and decreased urinary stream. Decreased urinary stream was more prominent in an elderly patient group, and urinary incontinence was observed almost at the same rate in all age-classified groups. Urodynamic studies were performed in 30 patients with cerebral palsy who were referred to with urological symptoms. The patients were classified into two groups according to the presence or absence of spinal cord lesions. In a group of 15 patients with spinal cord lesions, electromyography of the external sphincter demonstrated detrusor-sphincter dyssynergia (DSD) in 9, of whom 6 complained of decreased urinary stream; while in the group without spinal cord lesions there was no DSD. These findings suggest that the cause of decreased urinary stream in cerebral palsied patients could be explained by DSD secondary to spinal cord lesions.