Urinary Incontinence in Children and Adolescents with Mental and Physical Disabilities: Comorbidities and Barriers

Abstract

Continence is one of those clinical conditions that one seldom thinks about if he/she does not have a problem. It to the insurgence and persistence of chronic kidney disease (CKD) and to renal/intestinal failure. Patients with disabilities represent a particularly challenging group, and when growing into adolescents and young adults, they belong to an indeed difficult and unique age group. Currently the published literature on this subject is limited. Many groups have not focused on these nonglamorous aspects of bladder and bowel care. Management of bladder and bowel dysfunction becomes more difficult if associated with disabilities and during the transition between childhood and adulthood. The challenges become enormous if adolescents and young adults are also disabled with unique comorbidities associated and/or leading to bladder and bowel problems. In the presence of obvious physical (motility/sensitivity) and psychological (neurodevelopmental delays, autism, etc.) additional limitations, tailored management needs to be defined. Children with lower IQ associated with physical disability and/or syndromes have an increased risk of incontinence. In this chapter we highlight the need and importance of identifying comorbidities associated with bladder and bowel problems in children and during the delicate transitional phase of adolescence, in individuals affected by disabilities, and to suggest adequate solution to overcome barriers and provide long-term surveillance.