Cerebral palsy and incontinence can, unfortunately, occur alongside each other. Although most children with cerebral palsy learn to control bladder and bowel incontinence, it is common for toilet training to take longer and require extra support. Cerebral palsy incontinence can negatively affect quality of life, so helping your child manage the condition is extremely important.
Is There a Link Between Cerebral Palsy and Incontinence?
Yes — bladder and bowel incontinence are common problems affecting children and adults with cerebral palsy. 70-80% of cerebral palsy patients have issues with incontinence, and 85% of patients have bladder overactivity. This may be due to neurological impairment.
“Children with cerebral palsy gain bladder and bowel control at an older age compared to typical developing children. The incidence of urinary incontinence during day and night, fecal incontinence and constipation is higher in this population.”
— National Institutes of Health (NIH)
According to an NIH study, even though there is a known link between cerebral palsy and incontinence, treatment strategies have been poorly investigated. Sadly, cerebral palsy incontinence is generally considered a normal, minor problem.
The good news is that there are many options to help those suffering from cerebral palsy incontinence.
What Causes Cerebral Palsy Incontinence?
A common characteristic of cerebral palsy is that the condition limits how much control patients have over their body parts.
Cerebral palsy also causes abnormal muscle tone and muscle spasticity, which can affect muscles that control bladder and bowel movements. Muscle spasticity happens when muscles involuntarily contract.
On the other hand, when the bowel and bladder muscles don’t contract, the body retains waste. This can cause constipation or urinary tract infections.
Cerebral palsy incontinence may also be caused by damage to the nervous system that affects the detrusor (the muscle that makes up the wall of the bladder) in a condition called neurogenic bladder. Neurogenic bladder may cause frequent, urgent, or painful urination.
The different types of neurogenic bladder include:
- Overactive bladder: The bladder is unable to empty fully or begins to empty before the person can make it to the bathroom.
- Overflow incontinence: urinary leakage occurs due to the bladder not emptying.
- Stress incontinence: The muscles that control urination do not function properly.
- Urge incontinence: Spasms of the bladder cause it to shrink before the person reaches the bathroom.
Being unable to control urination is the most common type of cerebral palsy incontinence.
Will My Loved One Develop Cerebral Palsy Incontinence?
Unfortunately, cerebral palsy incontinence can be difficult to predict, especially early on. This is because it can take months or years for a child to show noticeable symptoms of cerebral palsy after birth. Furthermore, it takes several years for a child to be properly potty trained.
However, there are several factors that may be indicators of future cerebral palsy incontinence.
- Severity of motor impairments: Usually, the more severe the impairment, the greater the risk of cerebral palsy incontinence.
- Location of motor impairments: Patients with spastic cerebral palsy are less likely to experience cerebral palsy incontinence.
- Intellectual disability: If intellectual disability is present, cerebral palsy incontinence is more likely since patients may not know what to do when they need to use the bathroom.
- Communication skills: If a person with cerebral palsy can express when they need to use the bathroom, accidents are less likely to happen.
- Age: Studies have shown it takes longer for patients with cerebral palsy to develop bladder and bowel management skills.
“The age of achieving bladder and bowel control was higher in children with cerebral palsy than in healthy children. Most healthy children achieve bladder and bowel control at the age between 2 and 4 years. However, disabled children gain this control at an older age.”
— National Institutes of Health
Ways To Manage Cerebral Palsy Incontinence
There are several approaches to treat cerebral palsy incontinence. Generally speaking, the sooner problems are identified, the better the outcome will be.
Options to manage cerebral palsy incontinence include:
- Incontinence training: This program involves sticking to a schedule for emptying the bowel and bladder at roughly the same time every day.
- Wearing a diaper: This is especially helpful when your child is just starting incontinence training or taking new medications for incontinence.
- Medications: A commonly used bladder control medication is Tofranil, which contracts the bladder neck muscles. Desmopressin acetate (DDAVP), a diabetes medication that helps to control thirst and too much urination, may also be used. Cerebral palsy bowel incontinence medications include bulking agents and antidiuretics.
- Urotherapy: This nonsurgical treatment includes providing information on lifestyle changes, fluid intake, and keeping bladder diaries. It may also include pelvic floor training and electrical stimulation.
- Catheter: A narrow tube is inserted to drain urine from the bladder either by inserting the tube every 4-6 hours (intermittent catheterization) or wearing a catheter at all times (indwelling catheterization).
- Bladder augmentation: This is surgery to expand bladder size to hold more urine.
- Botox: In adults with cerebral palsy, Botox injections may be given to relax bladder muscles by blocking nerve signals.
Resources for Cerebral Palsy and Incontinence
Cerebral palsy incontinence is often treatable. While some of the most effective treatment options for cerebral palsy and incontinence can be expensive, there may be resources available to help families afford them.
A child's cerebral palsy and the lifelong challenges that come along with it, including cerebral palsy incontinence, may have been caused by improper medical care during birth.
In these cases, families can pursue legal compensation from the doctors that failed to keep their child safe. The money awarded in a cerebral palsy lawsuit can help pay for your child’s care.
If your child suffers from cerebral palsy, get a free case evaluation without delay to learn if you can take legal action.