Urodynamic patterns in pediatric patients with cognitive developmental disorders: A retrospective descriptive study

Area of Science:

• Pediatric Urology
• Neurodevelopmental Disorders
• Urodynamics

Background:

• Cognitive developmental disorders (CDD) like intellectual disability (ID), cerebral palsy (CP), and autism spectrum disorder (ASD) are frequently linked to lower urinary tract dysfunction.
• Understanding these associations is crucial for effective patient management.

Purpose of the Study:

• To characterize urodynamic (UD) patterns in pediatric patients with CDD.
• To analyze the relationship between UD findings, clinical variables, and treatment outcomes in this population.

Main Methods:

• Retrospective observational study of 79 pediatric patients (ages 4-17) with confirmed CDD undergoing video urodynamic evaluations.
• Analysis of urodynamic parameters, clinical diagnoses (CP, ID, ASD, DS), vesicoureteral reflux (VUR), and treatment modalities.
• Statistical examination of associations between CDD type and UD parameters using chi-square tests.

Main Results:

• Dysfunctional voiding was common, especially in CP and ASD. Detrusor overactivity was frequent in ID and CP, while detrusor-sphincter dyssynergia was prevalent in CP and ID.
• Decreased bladder compliance was noted in ID and CP patients, but preserved in ASD. Absent urgency sensation occurred in CP and ID.
• Vesicoureteral reflux (VUR) was observed in ASD and CP. Invasive management, including clean intermittent catheterization and surgery, was frequently required for CP patients.

Conclusions:

• Distinct urodynamic profiles exist for different CDDs, with CP showing neurogenic patterns and ID exhibiting storage dysfunction.
• ASD patients demonstrated preserved bladder compliance, suggesting behavioral or sensory issues. Urodynamic studies are vital for personalized diagnosis and management in children with CDD.