- patients who have had a UTI ;
- persistent daytime incontinence despite a good training approach (see Toilet Training Children With Disability). Note: with the appropriate approach, even children with moderately severe cognitive and motor impairments can achieve continence;
- changes in bladder function, particularly if after intervention for spasticity with a Dorsal Rhizotomy;
- in children with any of the following symptoms:
- high voiding frequency or urgency;
- difficulty initiating a void;
- stress incontinence; and
- persistent nighttime wetting after a period of daytime continence. (Note: an empiric trial of ditropan might be considered in those with symptoms of bladder spasticity).
- urodynamics (Cystometrogram/CMG);
- renal ultrasound;
- VCUG (if there has been a UTI); and
- a urinalysis.
McNeal DM, Hawtrey CE, Wolraich ML, Mapel JR.
Symptomatic neurogenic bladder in a cerebral-palsied population.
Dev Med Child Neurol. 1983;25(5):612-6. PubMed abstract
This is an older article but the only one that looks at urinary symptoms in a general clinic population of children with CP.
Reid CJ, Borzyskowski M.
Lower urinary tract dysfunction in cerebral palsy.
Arch Dis Child. 1993;68(6):739-42. PubMed abstract / Full Text
This article describes clinical features and management of a cohort of children with CP referred to a urology clinic.
|Author:||Lisa Samson-Fang, MD - 10/2008|
|Content Last Updated:||2/2014|