Urodynamic study findings and related influential factors in pediatric spastic cerebral palsy
Wenbin Jiang1, Huizhen Sun2, Baojun Gu3
1Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, 355 Luding Road, Shanghai, 200062, China.
Insights
Pediatric spastic cerebral palsy (CP) patients often show abnormal urodynamic study (UDS) results. Motor function, age, and nerve root thresholds significantly impact bladder dysfunction in children with CP.
Area of Science:
- Pediatric Urology
- Neurology
- Rehabilitation Medicine
Background:
- Spastic cerebral palsy (CP) is a common childhood neurological disorder affecting motor function.
- Urodynamic studies (UDS) are crucial for evaluating lower urinary tract function.
- Understanding UDS findings in pediatric CP patients is essential for management.
Purpose of the Study:
- To investigate urodynamic study (UDS) results in pediatric patients with spastic cerebral palsy (CP).
- To identify correlations between clinical factors and abnormal UDS findings.
Main Methods:
- Retrospective review of medical records of pediatric CP patients who underwent pre-operative UDS before selective dorsal rhizotomy (SDR).
- Data collected included age, ambulatory status, Gross Motor Function Measure-66 (GMFM-66) scores, and UDS parameters.
- Statistical analysis was performed to assess relationships between variables.
Main Results:
- Abnormal UDS results were prevalent in 57 pediatric CP patients (mean age 6.73 years).
- Reduced bladder capacity occurred in 49.12%, associated with lower GMFM-66 scores (p<0.01).
- Detrusor overactivity (DO) was present in 33.33%, more common in younger (p<0.05) and non-ambulatory patients (p<0.05).
- Increased post-voiding residual (PVR) was observed in 21.05%, linked to higher sphincter-associated nerve root thresholds (p<0.05).
Conclusions:
- Pediatric patients with spastic CP frequently exhibit abnormal urodynamic findings.
- Motor function, age, and specific nerve root characteristics influence bladder dysfunction.
- These findings highlight the importance of UDS in managing urinary issues in pediatric CP.
Abstract:
To investigate the urodynamic study (UDS) result in pediatric patients suffering from spastic cerebral palsy (CP). Medical records of patients diagnosed CP having pre-operative UDS results underwent selective dorsal rhizotomy (SDR) from Jan. 2020 to May. 2021 were retrospectively reviewed. Fifty-seven cases diagnosed spastic CP were included in the study (mean age, 6.73 ± 2.84 years), among which, 46 were ambulatory and 11 non-ambulatory. Average gross motor function measure-66 (GMFM-66) score was 62.16 ± 11.39. Reduced bladder capacity was seen in 49.12% of these cases and cases with lower GMFM-66 score possessed a higher incidence rate of having low bladder capacity (p < 0.01). Detrusor overactivity (DO) was shown in 33.33% of the patients. Cases with younger age presented a higher prevalence of DO (p < 0.05). Meanwhile, more non-ambulant patients suffered from DO (p < 0.05). Increased post-voiding residual (PVR) was seen in 21.05% of the cases. Those with higher average threshold in sphincter-associated input spinal nerve roots (rootlets) witnessed a higher rate of having abnormal PVR (p < 0.05). Abnormal UDS results were prevalent in pediatric patients suffering from CP. Motor function, age and threshold of their sphincter-associated spinal nerve roots laid corresponding effect on the abnormal UDS results.
