Urodynamic Findings in Children with Cerebral Palsy Before Dorsal Rhizotomy Surgery

Abstract

Objective:This study aims to investigate the neurourological and urodynamic findings of children with cerebral palsy (CP) that referred for dorsal rhizotomy surgery (DRS).Materials and Methods:All children with CP who were scheduled for selective DRS were assessed with a detailed medical history, physical exam, urinalysis and urodynamic studies to assess bladder function and urinary problems. Urodynamic studies included filling and voiding cystometry, detrusor leak point pressure, external anal sphincter electromyography, flow rate and residual urine volume. All investigations and definitions relied on the standardisation of the International Continence Society.Results:Overall, 24 boys and 10 girls were evaluated. The mean age of boys, and girls and the study group was 6.6 (1.7-9.8), 6.5 (3.5-11.4) and 6.6 (1.7-11.4) years, respectively. The most common complaints of the study group were urinary incontinence (58.8%), encopresis (32.4%) and constipation (17.6%) and 41.2% of patients needed diapers due to these problems. Twenty-five per cent (n=5) of male patients had an undescended testis. The most common clinical conditions at urodynamics, were low bladder compliance (85.3%), detrusor overactivity (67.6%), hyposensitive bladder (52.6%) and low bladder capacity (41.2%).Conclusion:Upper motor neuron lesions, like CP, may present with various urodynamic findings. However, patients with CP are not routinely seen by urologists. Our findings revealed serious neurological problems in children referred for DRS. Therefore, every child with CP who has a DRS plan should undergo a detailed urological examination at least once before the procedure.

Keywords

• cerebral palsy
• child
• urology
• urodynamics
• rhizotomy