Article Text

URINARY INCONTINENCE IN CHILDREN WITH NEURODEVELOPMENT AND BEHAVIOUR DISORDERS
  1. S M Lima1,
  2. A L Pinto1,
  3. L Soares1,
  4. V Monteiro1
  1. 1Department of Paediatrics, Hospital Sao Miguel, Oliveira Azemeis, Portugal

Abstract

Introduction Some studies report an association between attention deficit hyperactivity disorder or children with cerebral palsy and voiding dysfunction. The most important reason to investigate and treat children with urinary incontinence is to improve self-esteem and secondary psychological or behavioural problems that may develop.

Materials and Methods Retrospective study of patients with urinary incontinence associated with neurodevelopment and behaviour disturbances followed in the units of development and paediatric nephrology ambulatory care, between January 2000 and December 2007, at a district hospital. Patients were identified on the hospital computer database and files were consulted from the hospital archives. The evaluated parameters were age of referral, sex, work-up, diagnosis, treatment and follow-up.

Results 62 patients were included, with male predominance (68%). The median age of referral to paediatric nephrology was 7.7 years (range 5–13 years). The most common neurodevelopmental and behavioural disorders were global development delay (45%) and attention deficit hyperactivity disorder (26%). The major cause of urinary incontinence was enuresis, affecting 43 patients. Three patients were found to have neurogenic bladder. The most common treatments were desmopressin (68%) and oxybutynin (40%), with some patients needing more than one drug. There was a good response to treatment in the majority of cases, with improvement seen in 55 patients (89%).

Conclusions Children with neurodevelopmental and behavioural disorders also have a good response to specific treatment for urinary incontinence. This means that in the presence of symptoms, these children should be evaluated and treated in the same way as the general population.

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