Study of urinary disorders in a cohort of 137 adult patients with cerebral palsy

Abstract

Adults with cerebral palsy can have lower urinary tract dysfunction with organic complications and impact on quality of life. Theses troubles are well known in pediatric population but have been less studied among adults with cerebral palsy. The aim of this study was to describe lower urinary tract dysfunction, complications, and urodynamic profiles in our population of adults with cerebral palsy. Between 2009 and 2015, 137 adults with cerebral palsy, followed in our department, were included (anyway the reason of their visit) and data were analysed retrospectively. We studied clinical parameters (gender, age, neurological clinical picture, clinical picture severity, reason for their visit, lower urinary tract dysfunction, complications) and paraclinical data (renal bladder ultrasound, renal function, urodynamic). Sixty-six men and 71 women with cerebral palsy, 36.4 years old mean, GMCSF 4 median were included. For 23 patients (16.8%), we did not have any data about their vesical status. Twenty-eight patients (20.4%) consulted for a lower urinary tract dysfunction. Eighty-eight patients (64.2%) had urinary troubles: 59 (43.1%) reported voiding symptoms, 72 (52.6%) storage symptoms and 43 (31.3%) both. Forty-nine (35.8%) had complications on bladder or kidney. Especially, renal function was altered among 24 patients (17,5%) and 26 (19%) had multiple urinary tract infections. Forty-eight patients (35%) had urodynamic explorations, sphincter hypertonia was the most frequent anomaly [ n = 31 (22.6%)], associated with dysuria in 19 patients. GMCSF in symptomatic adults was higher than no symptomatic adults ( P < 0.0001). This study shows that lower urinary tract dysfunctions are frequent in adults with cerebral palsy, with an impact on their health and quality of life. As a consequence, a minimal systematic screening may be proposed.