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Cerebral Palsy pp 1–17Cite as

Neurogenic Bladder in Cerebral Palsy: Upper Motor Neuron

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Abstract

Although most children with cerebral palsy can eventually develop total urinary control, more than 50% of them suffer from a spectrum of lower urinary tract symptoms. The severity of urinary symptoms depends on the extent of motor, mental, cognitive, and neurological disabilities associated with cerebral palsy. While routine urological evaluation in children with cerebral palsy is not indicated as in the case in children with spinal dysraphism, physicians who care for children with cerebral palsy should be familiar with urological manifestations of the disorder and refer children with voiding complaints for urological work up. Common lower urinary tract complaints in children with cerebral palsy include delay in toilet training, urinary incontinence, urinary frequency, urgency, hesitancy in voiding, incomplete emptying, and recurrent urinary tract infections. Urodynamic studies in select cerebral palsy patient populations demonstrate detrusor overactivity, reduced bladder capacity, detrusor-sphincter dyssynergy, and rarely impaired bladder compliance and upper urinary tract deterioration. In this chapter, we discuss the physiology of bladder function, urological presentations, diagnostic work up, and management of children with cerebral palsy.

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References

  • Allen HA et al (2007) Initial trial of timed voiding is warranted for all children with daytime incontinence. Urology 69(5):962–965

    Article  PubMed  Google Scholar 

  • Appell RA et al (2001) Prospective randomized controlled trial of extended-release oxybutynin chloride and tolterodine tartrate in the treatment of overactive bladder: results of the OBJECT study. Mayo Clin Proc 76(4):358–363

    Article  CAS  PubMed  Google Scholar 

  • Blackburn SC et al (2013) Intravesical botulinum type-A toxin (Dysport®) in the treatment of idiopathic detrusor overactivity in children. Journal of Pediatric Urology 9(6 Pt A):750–753

    Article  CAS  PubMed  Google Scholar 

  • Blais A-S et al (2016) Prospective pilot study of Mirabegron in pediatric patients with overactive bladder. Eur Urol 70(1):9–13

    Article  PubMed  Google Scholar 

  • Bolduc S et al (2010) Prospective open label study of solifenacin for overactive bladder in children. J Urol 184(4 Suppl):1668–1673

    Article  PubMed  Google Scholar 

  • Brodak PP et al (1994) Is urinary tract screening necessary for patients with cerebral palsy? J Urol 152(5 Pt 1):1586–1587

    Article  CAS  PubMed  Google Scholar 

  • Bross S et al (2007) Correlation between motor function and lower urinary tract dysfunction in patients with infantile cerebral palsy. Neurourol Urodyn 26(2):222–227

    Article  PubMed  Google Scholar 

  • Cartwright PC et al (2009) Efficacy and safety of transdermal and oral oxybutynin in children with neurogenic detrusor overactivity. J Urol 182(4):1548–1554

    Article  CAS  PubMed  Google Scholar 

  • Cotter KJ et al (2016) Urodynamic findings in adults with moderate to severe cerebral palsy. Urology 95:216–221

    Article  PubMed  Google Scholar 

  • Decter RM et al (1987) Urodynamic assessment of children with cerebral palsy. J Urol 138(4 Pt 2):1110–1112

    Article  CAS  PubMed  Google Scholar 

  • Drigo P et al (1988) Neurogenic vesico-urethral dysfunction in children with cerebral palsy. Ital J Neurol Sci 9(2):151–154

    Article  CAS  PubMed  Google Scholar 

  • Dwyer ME et al (2014) Sacral neuromodulation for the dysfunctional elimination syndrome: a 10-year single-center experience with 105 consecutive children. Urology 84(4):911–917

    Article  PubMed  Google Scholar 

  • Ersöz M et al (2009) Noninvasive evaluation of lower urinary tract function in children with cerebral palsy. Am J Phys Med Rehabil 88(9):735–741

    Article  PubMed  Google Scholar 

  • Fairhurst JJ et al (1991) Bladder capacity in infants. J Pediatr Surg 26(1):55–57

    Article  CAS  PubMed  Google Scholar 

  • Goldfarb RA et al (2016) Neurogenic lower urinary tract dysfunction in adults with cerebral palsy: outcomes following a conservative management approach. J Urol 195(4 Pt 1):1009–1013

    Article  PubMed  Google Scholar 

  • Groen L-A et al (2012) Sacral neuromodulation with an implantable pulse generator in children with lower urinary tract symptoms: 15-year experience. J Urol 188(4):1313–1317

    Article  PubMed  Google Scholar 

  • Gündoğdu G et al (2013) Relationship of bladder dysfunction with upper urinary tract deterioration in cerebral palsy. J Pediatr Urol 9(5):659–664

    Article  PubMed  Google Scholar 

  • Hoebeke P et al (2006) The effect of botulinum-a toxin in incontinent children with therapy resistant overactive detrusor. J Urol 176(1):328–330, discussion 330–331

    Article  CAS  PubMed  Google Scholar 

  • Hunter KF, Bharmal A, Moore KN (2013) Long-term bladder drainage: suprapubic catheter versus other methods: a scoping review. Neurourol Urodyn 32(7):944–951

    Article  PubMed  Google Scholar 

  • Jansson U-B et al (2005) Voiding pattern and acquisition of bladder control from birth to age 6 years--a longitudinal study. J Urol 174(1):289–293

    Article  PubMed  Google Scholar 

  • Karaman MI et al (2005) Urodynamic findings in children with cerebral palsy. Int J Urol 12(8):717–720

    Article  PubMed  Google Scholar 

  • Kilicarslan H et al (2006) Treatment of detrusor sphincter dyssynergia with baclofen and doxazosin. Int Urol Nephrol 38(3–4):537–541

    CAS  PubMed  Google Scholar 

  • Kinlaw AC et al (2017) Trends in pharmacotherapy for bladder dysfunction among children in the United States, 2000 to 2013. Clin Pediatr 56(1):55–64

    Article  Google Scholar 

  • Koff SA (1983) Estimating bladder capacity in children. Urology 21(3):248

    Article  CAS  Google Scholar 

  • Krach LE (2001) Pharmacotherapy of spasticity: oral medications and intrathecal baclofen. J Child Neurol 16(1):31–36

    Article  CAS  PubMed  Google Scholar 

  • Largo RH, Stutzle W (1977) Longitudinal study of bowel and bladder control by day and at night in the first six years of life. I: epidemiology and interrelations between bowel and bladder control. Dev Med Child Neurol 19(5):598–606

    Article  CAS  PubMed  Google Scholar 

  • Leyson JF, Martin BF, Sporer A (1980) Baclofen in the treatment of detrusor-sphincter dyssynergia in spinal cord injury patients. J Urol 124(1):82–84

    Article  CAS  PubMed  Google Scholar 

  • Lopez Pereira P et al (2003) Trospium chloride for the treatment of detrusor instability in children. J Urol 170(5):1978–1981

    Article  CAS  PubMed  Google Scholar 

  • MacLellan DL, Bauer SB (2016) Neuromuscular dysfunction of the lower urinary tract in children. In: Wein AJ et al (eds) Campbell-Walsh Urology. Elsevier, Philadelphia, pp 3272–3296

    Google Scholar 

  • Malhotra B et al (2012) Dose-escalating study of the pharmacokinetics and tolerability of fesoterodine in children with overactive bladder. J Pediatr Urol 8(4):336–342

    Article  PubMed  Google Scholar 

  • Marciniak C et al (2014) Urinary incontinence in adults with cerebral palsy: prevalence, type, and effects on participation. PM & R 6(2):110–120, quiz 120

    Article  Google Scholar 

  • Marte A et al (2010) Effectiveness of botulinum-a toxin for the treatment of refractory overactive bladder in children. Eur J Pediatric Surg/Zeitschrift fur Kinderchirurgie 20(3):153–157

    CAS  Google Scholar 

  • Mayo ME (1992) Lower urinary tract dysfunction in cerebral palsy. J Urol 147(2):419–420

    Article  CAS  PubMed  Google Scholar 

  • McKenna PH et al (1999) Pelvic floor muscle retraining for pediatric voiding dysfunction using interactive computer games. Journal Urol 162(3 Pt 2):1056–1062, discussion 1062–3

    Article  CAS  Google Scholar 

  • Morin F et al (2017) Dual therapy for refractory overactive bladder in children: a prospective open-label study. J Urol 197(4):1158–1163

    Article  PubMed  Google Scholar 

  • Murphy KP, Boutin SA, Ide KR (2012) Cerebral palsy, neurogenic bladder, and outcomes of lifetime care. Dev Med Child Neurol 54(10):945–950

    Article  PubMed  Google Scholar 

  • Palmer LS (2016) Evaluation and targeted therapy of voiding dysfunction in children. Urology 92:87–94

    Article  PubMed  Google Scholar 

  • Pan D et al (2009) Long-term outcomes of external sphincterotomy in a spinal injured population. J Urol 181(2):705–709

    Article  PubMed  Google Scholar 

  • Reid CJ, Borzyskowski M (1993) Lower urinary tract dysfunction in cerebral palsy. Arch Dis Child 68(6):739–742

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Reinberg Y et al (2003) Therapeutic efficacy of extended release oxybutynin chloride, and immediate release and long acting tolterodine tartrate in children with diurnal urinary incontinence. J Urol 169(1):317–319

    Article  CAS  PubMed  Google Scholar 

  • Richardson I, Palmer LS (2009) Clinical and urodynamic spectrum of bladder function in cerebral palsy. J Urol 182(4 Suppl):1945–1948

    Article  PubMed  Google Scholar 

  • Roberts KB (2012) Revised AAP guideline on UTI in febrile infants and young children. Am Fam Physician 86(10):940–946

    PubMed  Google Scholar 

  • Roijen LE et al (2001) Development of bladder control in children and adolescents with cerebral palsy. Dev Med Child Neurol 43(2):103–107

    Article  CAS  PubMed  Google Scholar 

  • Samijn B et al (2017) Lower urinary tract symptoms and urodynamic findings in children and adults with cerebral palsy: a systematic review. Neurourol Urodyn 36(3):541–549

    Article  PubMed  Google Scholar 

  • Schurch B et al (1996) Botulinum-a toxin as a treatment of detrusor-sphincter dyssynergia: a prospective study in 24 spinal cord injury patients. J Urol 155(3):1023–1029

    Article  CAS  PubMed  Google Scholar 

  • Silva JAF et al (2010) Lower urinary tract dysfunction and ultrasound assessment of bladder wall thickness in children with cerebral palsy. Urology 76(4):942–945

    Article  PubMed  Google Scholar 

  • Silva JAF et al (2009) Lower urinary tract dysfunction in children with cerebral palsy. Neurourol Urodyn 28(8):959–963

    Article  PubMed  Google Scholar 

  • Thom M et al (2012) Management of lower urinary tract dysfunction: a stepwise approach. J Pediatr Urol 8(1):20–24

    Article  PubMed  Google Scholar 

  • Vainrib M, Reyblat P, Ginsberg DA (2014) Long-term efficacy of repeat incisions of bladder neck/external sphincter in patients with spinal cord injury. Urology 84(4):940–945

    Article  PubMed  Google Scholar 

  • Vricella GJ et al (2014) Long-term efficacy and durability of botulinum-a toxin for refractory dysfunctional voiding in children. J Urol 191(5 Suppl):1586–1591

    Article  CAS  PubMed  Google Scholar 

  • Youdim K, Kogan BA (2002) Preliminary study of the safety and efficacy of extended-release oxybutynin in children. Urology 59(3):428–432

    Article  PubMed  Google Scholar 

  • Young NL et al (2011) Reasons for hospital admissions among youth and young adults with cerebral palsy. Arch Phys Med Rehabil 92(1):46–50

    Article  PubMed  Google Scholar 

  • Yıldız N et al (2017) Cross-sectional study of urinary problems in adults with cerebral palsy: awareness and impact on the quality of life. Neurolo Sci 38(7):1193–1203

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Urology, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Hong Truong

  2. Division of Pediatric Urology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA

    Ahmad H. Bani Hani

  3. Department of Urology and Pediatrics, Sidney Kimmel Medical college-Thomas Jefferson University, Philadelphia, PA, USA

    Ahmad H. Bani Hani

Authors
  1. Hong Truong
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  2. Ahmad H. Bani Hani
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Corresponding author

Correspondence to Ahmad H. Bani Hani .

Editor information

Editors and Affiliations

  1. Alfred I. duPont Institute, Wilmington, DE, USA

    Freeman Miller

  2. Cerebral Palsy Program, AI DuPont Hospital for Children , Wilmington, DE, USA

    Steven Bachrach

  3. AI DuPont Hospital for Children , Wilmington, DE, USA

    Nancy Lennon

  4. Drexel University, PHILADELPHIA, PA, USA

    Margaret O'Neil

Section Editor information

  1. Nemours Alfred I. duPont Hospital for Children, Wilmington, DE, USA

    Freeman Miller

  2. Department of Pediatrics (Emeritus), Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA

    Steven J. Bachrach

  3. Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA

    Steven J. Bachrach

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Truong, H., Bani Hani, A.H. (2019). Neurogenic Bladder in Cerebral Palsy: Upper Motor Neuron. In: Miller, F., Bachrach, S., Lennon, N., O'Neil, M. (eds) Cerebral Palsy. Springer, Cham. https://doi.org/10.1007/978-3-319-50592-3_57-1

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  • DOI: https://doi.org/10.1007/978-3-319-50592-3_57-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-50592-3

  • Online ISBN: 978-3-319-50592-3

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