title: Relationship of bladder dysfunction with upper urinary tract deterioration in cerebral palsy.
abstract: Although lower urinary tract dysfunction (LUTD) in patients with cerebral palsy (CP) has been previously documented by clinical observations and urodynamic tests, its correlation with upper urinary tract deterioration (UUTD) has not been demonstrated. This paper documents symptoms and urodynamic findings of LUTD and their relationship with UUTD in 33 children with CP. By sonography, 4 of these children were found to have UUTD. Age was found to correlate with UUTD, but gender difference and mental or motor functions did not. When comparing urinary symptoms with UUTD, incontinence (n = 31) did not correlate, but on the other hand symptoms of detrusor sphincter dyssynergia (interrupted voiding, urinary retention, hesitancy; n = 5) and culture proven febrile urinary tract infections (n = 4) did. Abnormal urodynamics findings were not diagnostic. We conclude that, apart from incontinence, dysfunctional voiding symptoms and febrile urinary tract infections are valuable indicators of UUTD.
authors.affiliation: Pediatric Surgery, Bezmialem Vakif University, Medical Faculty, Department of Pediatric Surgery, Division of Pediatric Urology, Istanbul 34093, Turkey. ggundogdu1@yahoo.com
authors.forename: Gökhan
authors.initials: G
authors.lastname: Gündoğdu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kömür
authors.forename: Dinçer
authors.initials: D
authors.lastname: Avlan
authors.forename: Ferda Bacaksızlar
authors.initials: FB
authors.lastname: Sarı
authors.forename: Ali
authors.initials: A
authors.lastname: Delibaş
authors.forename: Bahar
authors.initials: B
authors.lastname: Taşdelen
authors.forename: Ali
authors.initials: A
authors.lastname: Naycı
authors.forename: Cetin
authors.initials: C
authors.lastname: Okuyaz
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D007670:Kidney Calices / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology; D014463:Ultrasonography; D001743:Urinary Bladder / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000150:complications; D016055:Urinary Retention / Q000150:complications / Q000503:physiopathology; D014551:Urinary Tract / Q000000981:diagnostic imaging / Q000503:physiopathology; D014555:Urination Disorders / Q000150:complications / Q000503:physiopathology*; D014563:Urodynamics