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19–22 APRIL, 2017, BARCELONA, SPAIN
S5: NEUROPATHIC BLADDER
Moderators: Lynne Bartlett (UK), Hanny Cobussen (Netherlands)
ESPU-Nurses Meeting on Friday 21, April 2017, 11:00–11:20
11:00–11:10
S5-1 (LO)
PREDICTIVE FACTORS FOR DAYTIME URINARY
INCONTINENCE IN CHILDREN WITH CEREBRAL PALSY
Bieke SAMIJN
1
, Christine VAN DEN BROECK
2
, Catherine RENSON
3
, Piet HOEBEKE
3
,
Johan VANDE WALLE
4
, Frank PLASSCHAERT
5
, Anne-Françoise SPINOIT
3
and Erik VAN LAECKE
3
1) Ghent University, Uro-gynaecology, Ghent, BELGIUM - 2) Ghent University, Physiotherapy and rehabilitation, Ghent,
BELGIUM - 3) Ghent University Hospital, Urology, Ghent, BELGIUM - 4) Ghent University Hospital, Pediatric Nephrology
and Rheumatology, Ghent, BELGIUM - 5) Ghent University Hospital, Orthopaedic Surgery, Ghent, BELGIUM
PURPOSE
The objective of the current study is to identify risk factors for the presence of daytime urinary
incontinence (DI) in children with Cerebral Palsy (CP).
MATERIAL AND METHODS
A prospective study including 34 children with CP and DI and 45 continent children with CP was
conducted between 2013 and 2016. Data was obtained using uroflowmetry, questionnaires and
bladder diaries. Factors were subdivided in three clusters, i.e. CP classification, general medical
data and bladder and bowel symptoms.
Univariate analysis was performed to determine predictive factors for incontinence. Odds Ratio
(OR) with 95% confidence interval was calculated. Clustered logistic regression using a stepwise
backward selection procedure was then constructed to define an associative model using one factor
from each cluster.
RESULTS
Concerning classification of CP dyskinesia (OR 5.67), combined spasticity/dystonia (OR 4.78),
bilateral involvement (OR 4.05), quadriplegia (OR 6.07) and gross motor function classification
system (GMFCS) level IV (OR 10.63) and V (OR 34.00) were associated with DI. Concerning
general medical data and bladder and bowel symptoms intellectual disability (OR 7.70), use of
mobility and positioning aids (OR 27.50), fecal incontinence (OR 5.16), lower maximum voided
volume (OR 0.97), being unable to void on uroflowmetry (complete separation between groups)
and lower oral fluid intake (OR 0.96) were associated with DI. Clustered logistic regression defined
GMFCS, intellectual disability and oral fluid intake as factors included in an associative model for
DI in children with CP.
CONCLUSIONS
Risk analysis revealed that CP classification, intellectual disability and fluid intake are important
factors when considering the ability of being dry in a child with cerebral palsy.