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Bladder and Bowel Dysfunction Rehabilitation in Children with Acquired Brain Injury

Rita Chiminello1, Chiara Pellegrino2, Noemi Deanesi2,3

  • 1Neurorehabilitation Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.

Children (Basel, Switzerland)
|November 27, 2024
PubMed

Insights

Neurogenic bladder and bowel dysfunction (NBBD) is common in children with cerebral palsy (CP) and acquired brain injury (ABI), similar to spinal cord injury (SCI). Higher disability levels correlate with increased symptom incidence.

Area of Science:

  • Neuroscience
  • Pediatric Rehabilitation
  • Urology

Background:

  • Neurogenic bladder and bowel dysfunction (NBBD) is often considered less frequent in children with cerebral palsy (CP) and acquired brain injury (ABI) compared to spinal cord injury (SCI).
  • Understanding NBBD in CP and ABI populations is crucial for effective management and improving quality of life.

Purpose of the Study:

  • To evaluate the prevalence of NBBD in children with CP and ABI.
  • To investigate the relationship between NBBD and the grade of disability in these pediatric populations.

Main Methods:

  • Retrospective review of clinical data from patients aged 3-18 years admitted to a neurorehabilitation department.
  • Data collection included demographic parameters, disability status (Wee-FIM, GMFCS, CFCS), and urological/gastrointestinal symptoms using validated tools.
  • Sixty patients were enrolled: 30 with CP, 17 with ABI, 3 with SCI, and 10 with other neurological diseases.

Main Results:

  • All patients experienced urinary incontinence, with no significant gender differences.
  • CP and ABI showed high incidences of bowel dysfunction (50% and 64.7%), while SCI had higher rates of urinary tract infections (66.6%) and enuresis (100%).
  • Increased symptom severity was observed in patients with higher Gross Motor Function Classification System (GMFCS) levels (3-5).

Conclusions:

  • NBBD is highly prevalent in children with CP and ABI, comparable to SCI.
  • Pediatricians and pediatric urologists require increased awareness of NBBD in these patient groups.
  • Further research is necessary to elucidate the clinical relevance and establish specific management strategies for NBBD in children with CP and ABI.

Keywords:
acquired brain injurycerebral palsycontinenceneurogenic bladder dysfunctionneurogenic bowel dysfunctionpediatric urology

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