title: Bladder and bowel control in children with cerebral palsy: case-control study.
abstract: OBJECTIVE
  To determine the age of development of bladder and bowel control and the frequency of enuresis, encopresis, and urinary infections in children with cerebral palsy.
  
  
  METHODS
  The study included 45 children with cerebral palsy who regularly attended a rehabilitation center in Isparta, Turkey, and two groups of age- and sex-matched children, 37 siblings of the children with cerebral palsy and 37 healthy children. Demographic data and information on the age of development of total bladder and bowel control and presence of possible urinary symptoms in children were collected from their caregivers by use of a questionnaire. Frequency of enuresis and encopresis was estimated among the children aged > or =5 years. A mid-way urinary sample was obtained from 40, 22, and 21 children in the cerebral palsy, siblings, and healthy children, respectively.
  
  
  RESULTS
  The mean age of nighttime bladder and bowel control development was 47 months (95% confidence interval [CI], 35-58) and 45 (36-55) months, respectively, for the children with cerebral palsy, 35 months (95% CI, 24-46) and 26 months (95% CI, 24-28), respectively, for their siblings, and 27 months (95% CI, 22-33) and 25 months (95% CI, 23-27) months, respectively, for the healthy children. Among the children aged > or =5 years, enuresis was present in 11 of 34 children with cerebral palsy, 7 of 30 siblings, and 4 of 30 healthy children (P = 0.200), whereas encopresis was present in 5 children with cerebral palsy, one sibling, and one healthy child. Constipation was significantly more present in chidlren with cerebral palsy than in other two groups (P<0.001). Urine culture was positive in 13 children with cerebral palsy, 1 sibling, and 2 healthy chidlren (P = 0.024). There were no significant differences in other urinary symptoms and laboratory findings among the three groups.
  
  
  CONCLUSIONS
  The children with cerebral palsy gained bladder and bowel control at older age in comparison with their siblings and healthy children. They also had more frequent enuresis and urinary infections.
authors.affiliation: Department of Public Health, Suleyman Demirel University School of Medicine, Isparta, Turkey. muozturk@med.sdu.edu.tr
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozturk
authors.forename: Faruk
authors.initials: F
authors.lastname: Oktem
authors.forename: Nesimi
authors.initials: N
authors.lastname: Kisioglu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Demirci
authors.forename: Irfan
authors.initials: I
authors.lastname: Altuntas
authors.forename: Suleyman
authors.initials: S
authors.lastname: Kutluhan
authors.forename: Malik
authors.initials: M
authors.lastname: Dogan
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000209:etiology; D003672:Defecation; D004775:Enuresis / Q000209:etiology*; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D014552:Urinary Tract Infections / Q000150:complications; D014554:Urination; D014555:Urination Disorders / Q000209:etiology