Prevalence of Incontinence and Risk Factors in Children With Cerebral Palsy

Completed

• Conditions: Urinary Incontinence
• Interventions: Other: Questionnaire and micturition and drinking diaries; Procedure: Uroflowmetry, pelvic floor EMG and bladderscan

• Registration Number: NCT02368262
• Lead Sponsor: University Hospital, Ghent

Brief Summary

This study evaluates (risk)factors influencing (in)continence in children with and without a brain injury.

Detailed Description

Children with cerebral palsy (CP) (Rosenbaum, 2007) gain bladder and bowel control at older age compared to typical developing children (Ozturk, 2006). The incidence of urinary incontinence during day and night, fecal incontinence and constipation is higher in this population.

Incontinence in children is often treated with urotherapy. This is a nonsurgical, nonpharmacological treatment for lower urinary tract dysfunctions. Standard urotherapy is noninterventional and it includes giving information, instructions, advice regarding life-style, fluid intake and bladder diaries. Additionally specific interventions can be used, such as: various forms of pelvic floor training, behavioral modification, biofeedback, electrical stimulation and catheterization (Neveus, 2006). Recent research has proven urotherapy to be successful for the treatment of children with daytime incontinence (Mulders, 2010).

Despite the high prevalence of incontinence in children with CP the possible treatment strategies in this population are poorly investigated. Far too often, urinary incontinence in children with CP is considered a normal, unavoidable and even a minor problem.

Aim: Analyze (risk) factors influencing (in)continence in children with and without CP.

Possible parameters will be registered through questioning, measurement (uroflow combined with pelvic floor EMG and postmictional residue) and retrospective analysis of the patient files. Parameters will be compared between continent and incontinent children with and without CP. This comparison evaluates whether the same therapeutic strategies can be applied in incontinent children with and without CP.

Study Timeline

• Study Start: 2014-09
• Study First Submitted: 2015-02-13
• Study First Submitted QC: 2015-02-13
• Study First Posted: 2015-02-23
• Primary Completion: 2016-09
• Study Completion: 2016-12
• Status Verified: 2017-01
• Last Update Submitted: 2017-01-03
• Last Update Posted: 2017-01-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 79

Inclusion Criteria

• Daytime urinary incontinence with or without enuresis and/or fecal incontinence (Groups with incontinence)
• No urinary or fecal incontinence (Groups without incontinence)
• Cerebral palsy (Groups with children with CP)
• Normal development (Groups with children without CP)

Exclusion Criteria

• Isolated urinary tract infections
• Isolated enuresis
• Isolated dysfunctional voiding
• Isolated fecal incontinence
• Anatomical abnormalities
• History of genitourinary or renal surgery
• Medication for incontinence during the last 3 months
• Pelvic reeducation during the last 6 months
• Other neurologic problems influencing continence

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
CP- incontinent	Uroflowmetry, pelvic floor EMG and bladderscan	Children with CP and daytime incontinence. Evaluation consisted of a questionnaire and micturition and drinking diaries, uroflowmetry, pelvic floor EMG and bladderscan.
CP- continent	Questionnaire and micturition and drinking diaries	Children with CP without daytime incontinence. Evaluation consisted of a questionnaire and micturition and drinking diaries, uroflowmetry, pelvic floor EMG and bladderscan.
NoDev - incontinent	Questionnaire and micturition and drinking diaries	Children with normal development with daytime incontinence. Evaluation consisted of a questionnaire and micturition and drinking diaries, uroflowmetry, pelvic floor EMG and bladderscan.
NoDev - incontinent	Uroflowmetry, pelvic floor EMG and bladderscan	Children with normal development with daytime incontinence. Evaluation consisted of a questionnaire and micturition and drinking diaries, uroflowmetry, pelvic floor EMG and bladderscan.
CP- continent	Uroflowmetry, pelvic floor EMG and bladderscan	Children with CP without daytime incontinence. Evaluation consisted of a questionnaire and micturition and drinking diaries, uroflowmetry, pelvic floor EMG and bladderscan.
CP- incontinent	Questionnaire and micturition and drinking diaries	Children with CP and daytime incontinence. Evaluation consisted of a questionnaire and micturition and drinking diaries, uroflowmetry, pelvic floor EMG and bladderscan.
NoDev - continent	Uroflowmetry, pelvic floor EMG and bladderscan	Children with normal development without daytime incontinence. Evaluation consisted of a questionnaire and micturition and drinking diaries, uroflowmetry, pelvic floor EMG and bladderscan.
NoDev - continent	Questionnaire and micturition and drinking diaries	Children with normal development without daytime incontinence. Evaluation consisted of a questionnaire and micturition and drinking diaries, uroflowmetry, pelvic floor EMG and bladderscan.

Primary Outcome Measures

Name	Time	Method
Risk factors	Cross-sectional	Identification of predictive factors for incontinence in children with and without CP.

Trial Locations

Locations (1)

University Hospital, Ghent; 🇧🇪 Ghent, Belgium