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- Title
208: Urodynamic evaluation of cerebral palsy in Hong Kong.
- Authors
Chu Wing Hong; Chu Sau Kwan Peggy; Yiu Ming Kwong; Man Chi Wai
- Abstract
Introduction: To review the urodynamic findings in patients with cerebral palsy and the outcomes of their related therapies. Methods: From Jan 2000 to Dec 2007, 38 patients (19 male, 19 female) with cerebral palsy, aged 6 - 31 years (median 10.5) - were seen in neurourology or combined selective dorsal rhizotomy (SDR) clinic in Tuen Mun and Princess Margaret Hospital. The patterns of motor involvement include spastic hemiplegia/diplegia. They all suffered from different degree of mental retardation. Their medical records, radiological imaging and cystometric findings were reviewed. Treatment was started according to symptom, with clinical response being assessed in follow-up. Results: Of our study group, 30/38 (79%) patients had dysfunctional voiding symptoms: frequency, urgency and/or urge incontinence. 31/38 (82%) showed neurogenic detrusor overactivity on slow-fill cystometry. 4/38 (11%) had sonographic evidence of hydronephrosis. Symptomatic patients with urodynamic evidence of neurogenic detrusor overactivity were managed by antimuscarinic drug, clean intermittent catheterization or combination of both. 26 (68%) patients underwent selective dorsal rhizotomy. 32/38 (84%) enjoyed either symptom improvement or napkin-free status. Conclusions: Close to 80% of patients with cerebral palsy in our study group suffered from symptomatic dysfunctional voiding associated with neurogenic detrusor overactivity. Although only 11% of our patients had upper tract involvement, early referral to urologist with urodynamic assessement is recommended. By doing so, patients with cerebral palsy will have their lower urinary tract dysfunction better evaluated, thus preventing irreversible upper tract damage.
- Subjects
URODYNAMICS; HEALTH outcome assessment; PEOPLE with cerebral palsy; DEVELOPMENTAL disabilities; URINATION disorders; URINARY incontinence
- Publication
Indian Journal of Urology, 2008, Vol 24, pS123
- ISSN
0970-1591
- Publication type
Article