title: Lower urinary tract dysfunction in children with cerebral palsy.
abstract: OBJECTIVE
  The focus of this study was to evaluate urodynamic findings and possible renal damage in children with cerebral palsy and urinary symptoms.
  
  
  METHODS
  Children with cerebral palsy and lower urinary tract symptoms were studied. Patients were submitted to urodynamic evaluation, urine examination, measurement of serum creatinine, and renal and urinary tract ultrasonography. Voiding cystourethrography was performed on patients with urinary tract infections.
  
  
  RESULTS
  Thirty-seven children were investigated, including 21 females and 16 males. The mean age was 7 years and 8 months [SD of 4 years 6 months], with a range from 1 to 17-year-old. The symptoms that led to evaluation were urinary infections in 21 56.7% cases, incontinence in 15 (40.5%) cases, increased voiding frequency in six (16%) cases, enuresis in five (13.5%) cases, and hesitancy and urgency in two (5.4%) cases each. The urodynamic findings involved reduced bladder capacity in 20 (54%) cases, with mean cystometric capacity of 168.0 +/- 122.2 ml. Detrusor overactivity was observed in 13 (35.1%) cases, with mean of 67.9 +/- 34.6 cmH(2)O. The range of the residual volume was 17.5 +/- 33.5 ml, which was increased in five (13.5%) cases. Low bladder compliance was seen in four (10.8%) patients, mean bladder compliance of 22.2 +/- 12.2 ml/cmH(2)O. No hydronephrosis or reflux was observed.
  
  
  CONCLUSIONS
  Almost one-third of the patients with cerebral palsy and urinary symptoms presented with normal urodynamic findings. The most frequent findings were reduced bladder capacity, detrusor overactivity, and increased post-void residual. No urinary tract complications were observed.
authors.affiliation: Department of Urology, SARAH Network of Rehabilitation Hospitals, Belo Horizonte, MG, Brazil. ailton@sarah.br
authors.forename: José Ailton Fernandes
authors.initials: JA
authors.lastname: Silva
authors.forename: Ronaldo Alvarenga
authors.initials: RA
authors.lastname: Alvares
authors.forename: André Luis
authors.initials: AL
authors.lastname: Barboza
authors.forename: Raphael Temporão Maciel
authors.initials: RT
authors.lastname: Monteiro
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000503:physiopathology*; D014563:Urodynamics