[Urodynamic findings in patients with infantile cerebral palsy].
OBJECTIVE
Aim of study was to evaluate the urodynamic findings in patients with infantile cerebral palsy.


METHODS
In 29 patients (aged 3-53), a videourodynamic investigation was performed after evaluation of urological anamnesis, clinical assessment and sonographic determination of residual urine. The patients were divided into group 1 (23 symptomatic patients aged 5 years and older with recurrent urinary tract infection, pollakiuria or urinary incontinence) and group 2 (6 asymptomatic patients).


RESULTS
In group 1, 21/23 patients (91%) had reduced compliance (0.6 - 16.4 ml/cmH(2)O) and 16/23 patients (70%) increased leak point pressure (> 40 cmH(2)O). In all 23 patients, detrusor instability and detrusor sphincter dyssynergia (during voiding) was found. Fluoroscopy showed bladder trabeculation or diverticula in 14 patients (61%) and 2nd-3rd degree vesicoureterorenal reflux in 2 patients (9%). In group 2, 2/6 patients (33%) had reduced compliance (0.7 and 5.8 ml/cmH(2)O) and 4/6 (67%) increased leak point pressure (> 40 cmH(2)O). In 5/6 patients (83%), detrusor instability and detrusor sphincter dyssynergia was seen. Fluoroscopy showed bladder trabeculation in 3 patients (50%), whereas no reflux was observed. Only one of the 29 patients (3 %) showed no pathological videourodynamic or anamnestic findings.


CONCLUSIONS
We conclude that videourodynamic assessment should be performed in all patients with infantile cerebral palsy. The decision should not be based on clinical symptoms such as pollakiuria, recurrent urinary tract infection or urinary incontinence.
Urologische Universitätsklinik, Klinikum Mannheim gGmbH, Mannheim. stephan.bross@uro.ma.uni-heidelberg.de
S
S
Bross
S
S
Pomer
L
L
Döderlein
T
T
Knoll
M S
MS
Michel
G
G
Staehler
H J
HJ
Gerner
P
P
Alken
D000293:Adolescent; D000328:Adult; D002547:Cerebral Palsy / Q000175:diagnosis / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009122:Muscle Hypertonia / Q000175:diagnosis / Q000503:physiopathology; D001743:Urinary Bladder / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000175:diagnosis / Q000503:physiopathology; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000503:physiopathology; D014741:Video Recording