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

O Yokoyama, K Nagano, A Hirata

    Nihon Hinyokika Gakkai Zasshi. the Japanese Journal of Urology
    |April 1, 1989
    PubMed
    Summary

    Cerebral palsy patients often experience urinary incontinence and decreased urinary stream. Spinal cord lesions can cause detrusor-sphincter dyssynergia (DSD), leading to a reduced urinary stream in these individuals.

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    Area of Science:

    • Neurology
    • Urology
    • Rehabilitation Medicine

    Context:

    • Cerebral palsy (CP) affects numerous individuals, with a significant portion experiencing urological issues.
    • Understanding the specific urological challenges in CP is crucial for improving patient care and quality of life.

    Purpose:

    • To investigate the prevalence of urological symptoms in patients with cerebral palsy.
    • To explore the relationship between ambulation, age, spinal cord lesions, and urological dysfunction, particularly decreased urinary stream.
    • To identify the urodynamic basis for decreased urinary stream in CP patients.

    Summary:

    • A study of 132 cerebral palsy patients (age 5-59) revealed high rates of urinary incontinence (31.8%), decreased urinary stream (14.4%), and urinary tract infections (16.7%).

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  • Impaired ambulation correlated with increased urinary incontinence and decreased urinary stream. Decreased stream was more common in older patients.
  • Urodynamic studies in 30 symptomatic CP patients showed detrusor-sphincter dyssynergia (DSD) in 9 of 15 patients with spinal cord lesions, linked to decreased urinary stream. No DSD was observed in patients without spinal cord lesions.

    • Impact:

    • Findings suggest detrusor-sphincter dyssynergia secondary to spinal cord lesions is a primary cause of decreased urinary stream in cerebral palsy.
    • This research highlights the importance of urological assessment and urodynamic evaluation in managing CP patients with lower urinary tract symptoms.
    • Improved understanding of the pathophysiology can lead to targeted interventions and better management strategies for urological dysfunction in cerebral palsy.