Urodynamic Assessment of Children With Cerebral Palsy

Decter, Ross M.; Bauer, Stuart B.; Khoshbin, Shahram; Dyro, Frances M.; Krarup, Christian; Colodny, Arnold H.; Retik, Alan B.

doi:10.1016/s0022-5347(17)43518-x

Cited by 81 publications

(44 citation statements)

References 3 publications

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“…Decter et al 8 from Boston evaluated voiding functions including cystometrograms and electromyography findings of the external urinary sphincter in 57 children with CP. Eightysix percent of the children had evidence of an upper motorneuron injury.…”

Section: Snb Symptomatic Neurogenic Bladdermentioning

confidence: 99%

“…At least four were found to have a neurogenic bladder on urological assessment including cystometrograms. Significant improvement was identified in symptomatic patients on medication.Decter et al 8 from Boston evaluated voiding functions including cystometrograms and electromyography findings of the external urinary sphincter in 57 children with CP. Eightysix percent of the children had evidence of an upper motorneuron injury.…”

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confidence: 99%

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Cerebral palsy, neurogenic bladder, and outcomes of lifetime care

Murphy

Boutin

Ide

2012

Develop Med Child Neuro

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ABBREVIATION SNB Symptomatic neurogenic bladderAIM To determine the prevalence of symptomatic neurogenic bladder (SNB) and social and functional variables in a large sample of people with cerebral palsy (CP).METHOD The medical records of 214 individuals (96 females, 118 males) with CP between the years 1990 and 2000 were retrospectively reviewed. Individuals with frequency, urgency, or incontinence were assigned Gross Motor Function Classification System levels and underwent cystometrogram ⁄ electromyelogram studies. Neurogenic bladders were classified according to the nomenclature of the International Continence Society.RESULTS Fifty-two patients had hemiplegia, 42 diplegia, 117 quadriplegia, and three dyskinesia.Educational levels ranged from full special education to those with graduate degrees. Thirty-five individuals in our group aged 5 to 66 years had SNB with a prevalence of 16.4%. The median age for the entire population was 9 years 7 months and for those with SNB 12 years 4 months (range 5-57y). Over 80% of individuals who underwent investigation were found to have spastic hyperreflexic type bladders. Ninety-one percent obtained total continence or major improvement with conservative care. SNB was documented across the lifespan, educational spectrum, and functional level. Upper urinary tract pathology was infrequent.INTERPRETATION SNB is a common finding in individuals with CP. In most patients it is readily diagnosed and treated with conservative interventions.Incontinence has long been identified as a problem in people with cerebral palsy (CP).1-3 Neurogenic bladder has been associated with incontinence in the population with CP and is the focus of several studies. [4][5][6] McNeal et al.7 from the University of Iowa screened 50 patients with CP and 18 patients with one or more symptoms indicative of a neurogenic bladder were identified. At least four were found to have a neurogenic bladder on urological assessment including cystometrograms. Significant improvement was identified in symptomatic patients on medication.Decter et al. 8 from Boston evaluated voiding functions including cystometrograms and electromyography findings of the external urinary sphincter in 57 children with CP. Eightysix percent of the children had evidence of an upper motorneuron injury. Treatment protocols achieved continence in more than 75% of the children.Studies by Drigo et al., 9 Karaman et al., 10 and Bross et al. 11of children with CP all found urodynamic features consistent with neurogenic bladder, detrusor sphincter dyssynergia, and upper motoneuron etiology. As noted by Borzyskowski,12 there are many factors involved in bladder control in people with CP. These factors include age, cognitive and communication skills, mobility, and upper extremity function together with expectations, training, and a compatible living environment. Incontinence in the population with CP is, thus, much more complicated than a static pathology of the central nervous system and associated measured bladder function.The purpose of this study ...

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Section: Snb Symptomatic Neurogenic Bladdermentioning

confidence: 99%

mentioning

confidence: 99%

Cerebral palsy, neurogenic bladder, and outcomes of lifetime care

Murphy

Boutin

Ide

2012

Develop Med Child Neuro

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“…Decter et al [4] performed UDS on 57 patients aged 2-20 and found 91% had urgency, frequency and/or incontinence. Two had difficulty initiating flow and one was in retention.…”

Section: Discussionmentioning

confidence: 99%

Sacral neuromodulation and lower urinary tract dysfunction in cerebral palsy

Roth

2006

Int Urogynecol J

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Given the emerging role of sacral neuromodulation in treatment of neurogenic voiding dysfunction, the author describes the use of sacral neuromodulation in a patient with voiding dysfunction caused by cerebral palsy (CP). A 45-year-old patient with cerebral palsy presented with progressive complaints of urgency and overflow incontinence and was found to be in retention. She underwent sacral neuromodulation and had complete resolution of her symptoms. The literature of lower urinary tract dysfunction in CP is reviewed. It is concluded that sacral neuromodulation may be a valuable tool in treating storage and voiding disorders associated with CP.

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“…En la parálisis cerebral se ha descrito DNTUI en aproximadamente el 30 la 40 % de los afectados 81 . Sólo se han publicado casos clínicos de DNTUI en hidrocefalia normotensiva 82 .…”

Section: Otras Lesiones Corticalesunclassified

Factores pronósticos del tratamiento endoscópico del reflujo vesicoureteral en pacientes con lesión medular

Chamorro¹,

Salinas²,

Bolufer³

et al. 2013

Actas Urológicas Españolas

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A mis Padres AGRADECIMIENTOSEl desarrollo de esta tesis doctoral ha sido mucho mas extenso de lo que en un principio esperaba; desde sus comienzos, con las interminables tardes de recogidas de datos en el Hospital Nacional de Parapléjicos, hasta los últimos coletazos en el diseño de impresión han transcurrido más de 5 años. Durante ese tiempo: he cambiado mi lugar de residencia en múltiples ocasiones, incluido de país durante un tiempo; de trabajo y de otras muchas cosas. A pesar de ello, finalmente conseguí concluir el trabajo, que probablemente no hubiera podido terminar sin la ayuda de toda esa gente que me ha ido apoyando a lo largo de estos años.En primer lugar me gustaría agradecer al servicio de Urología del Hospital Nacional de Parapléjicos: (médicos, enfermeras, auxiliares y personal administrativo) porque sin ellos nunca habría sido posible realizar esta Tesis, además, por su importante labor asistencial, mejorando cada día la vida de los pacientes con lesión medular.Mi mas sincera gratitud a mis directores de tesis: Al Dr. Virseda, por su estímulo constante durante todo este tiempo y por su gran conocimiento que ha hecho realidad este proyecto, siempre demostrándome que en definitiva la investigación es una manera igual de importante, para ayudar a nuestros pacientes mejorando y alargando su vida.Al Dr. Salinas por su gran aportación continua a la urología funcional, incansable en su insistencia en que concluyera el trabajo, asentando las bases en la que está apoyado todo nuestro estudio.Al Dr. Esteban por el inagotable entusiasmo, que pone cada día en todo lo que realiza, haciendo que este proyecto saliera adelante, luchando porque la investigación en urología funcional siga adelante convirtiendo este campo de la urología en uno de los mas activos actualmente.Me gustaría agradecer al servicio de Urología del Hospital Virgen de la Salud: por su apoyo continuo, ayudándome a crecer como urólogo. De todos he aprendido, y han sido unos de los mejores años de mi vida. En especial quiero agradecer a la Dra. Buendía haber creído siempre en mí, apoyando todos los proyectos que me han ido surgiendo en todos estos años, enseñándome con paciencia todo lo que se. Gracias.También me gustaría agradecer a todo mi equipo en la Fundación Jimenez Díaz, por no ponerme nunca obstáculos para concluir esta tesis, robándoles algunas horas de trabajo que probablemente hayan tenido que realizar ellos.A mi familia, por su ejemplo en el trabajo:A mi madre, Amparo, por su inagotable insistencia, probablemente el motor más importante para que este trabajo esté concluido.A mi padre, Ricardo, por haberme ayudado en la maquetación de este proyecto, en un momento en el que el Word pudo mas que yo y estuve a punto de tirar la toalla.A mi hermana María, por el tiempo que esta tesis le haya podido robar, siempre sacándome una sonrisa en cualquier momento.A Elena: por haberme acompañado siempre, no dejándome nunca solo, orientándome cuando me perdía, y sobre todo haciendo que los momentos duros fueran mucho más fáciles.Muchas gracias.

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Urodynamic Assessment of Children With Cerebral Palsy

Cited by 81 publications

References 3 publications

Cerebral palsy, neurogenic bladder, and outcomes of lifetime care

Cerebral palsy, neurogenic bladder, and outcomes of lifetime care

Sacral neuromodulation and lower urinary tract dysfunction in cerebral palsy

Factores pronósticos del tratamiento endoscópico del reflujo vesicoureteral en pacientes con lesión medular

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