Noninvasive Evaluation of Lower Urinary Tract Function in Children with Cerebral Palsy

Objective: The aim of this study was noninvasive evaluation of voiding function in children with cerebral palsy. Design: Sixty children with cerebral palsy were enrolled in the study. Urinary system symptoms were recorded. Uroflowmetric tests were carried out, and postvoid residual volume was measured immediately after voiding by using a portable ultrasonic device developed for children. The expected age-related bladder capacity was calculated and compared with the observed bladder capacity. Uroflowmetric curves were evaluated and classified as normal (bell-shaped) and abnormal. Results: Thirty-three of the children (55%) were symptomatic. In 1 7 (28.3%) of the children, postvoid residual urine was observed. There was a statistically significant difference between the expected bladder capacity (271.6 ± 38.3 ml) and the observed bladder capacity (154.5 ± 111.8 ml) (P < 0.001). Observed bladder capacity was lower than the expected bladder capacity in 56 (93.3%) of the children. In the evaluation of the uroflowmetric charts, 22 (36.7%) children had abnormal curves. Conclusions: Bladder capacity is decreased in most children with cerebral palsy, and postvoid residue is present in an important proportion. Uroflowmetry and portable ultrasonic device combination is a noninvasive, well-tolerated, and efficient method in the first line evaluation of lower urinary tract function in children with cerebral palsy.