Cerebral Palsy Incontinence

4 min read

a mother holds her daughter, who has cerebral palsy

Cerebral palsy and incontinence often occur together. While many children with cerebral palsy (CP) eventually learn to manage bladder and bowel control, toilet training typically takes longer and requires additional support. Since incontinence can significantly impact a child’s quality of life, helping your child manage the condition is important for their well-being.

Does Cerebral Palsy Cause Incontinence?

While cerebral palsy doesn't directly cause incontinence, bladder and bowel problems are common in children and adults with the condition.

In fact, 70-80% of people with CP experience incontinence, and 85% have bladder overactivity. These problems are often caused by neurological impairments related to CP.

“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)

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 families facing cerebral palsy bathroom issues.

What Causes Cerebral Palsy Incontinence?

Cerebral palsy incontinence is caused by how the condition affects muscle control and the nervous system.

CP often leads to abnormal muscle tone and spasticity, meaning muscles contract involuntarily. This can impact the muscles that control urination and bowel movements, leading to incontinence.

When these muscles don’t function properly, the body may retain waste, which can result in constipation or urinary tract infections (UTIs).

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).

This condition is called neurogenic bladder and 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.

The most common form of incontinence in cerebral palsy is difficulty controlling urination.

Does Cerebral Palsy Affect Bowel Movements?

Yes, cerebral palsy can affect bowel movements because it impacts muscle control and coordination.

Children and adults with CP often have muscle spasticity or weakness, which can make it harder to control the muscles that manage bowel movements.

This can lead to problems like constipation or bowel incontinence.

Constipation is common since the muscles that move stool through the intestines may not work properly. Low muscle tone, mobility limitations, and medications can also slow things down, causing hard stools and discomfort.

Cerebral palsy bowel incontinence happens when someone with the condition can’t control the muscles around the rectum, leading to accidental bowel movements.

Sometimes, nerve damage — called neurogenic bowel — can further disrupt communication between the brain and bowels, making control even harder.

Managing bowel movements for those with CP might involve a mix of dietary changes, medication, physical therapy, and, in some cases, surgery.

Will My Child Develop Cerebral Palsy Incontinence?

Unfortunately, cerebral palsy incontinence can be challenging 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.

Additionally, cerebral palsy potty training often takes several years to achieve due to the muscle control challenges that come with the condition.

However, there are several factors that may be indicators of future cerebral palsy incontinence.

These factors may predict whether your child will have cerebral palsy bathroom issues:

  • 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.

Children with cerebral palsy often take longer to develop bladder and bowel control compared to children without CP.

While most children gain control between the ages of 2-4, children with disabilities, including those with cerebral palsy, often reach this milestone at an older age, according to the National Institutes of Health.

10 Tips for Managing Cerebral Palsy Incontinence

Managing incontinence can be challenging, but these practical tips can help improve your child's quality of life and reduce stress for parents and caregivers.

Here are 10 ways to manage cerebral palsy incontinence:

  1. Stick to a regular bathroom schedule (incontinence training).
  2. Use diapers or absorbent products for support, especially during training.
  3. Talk to your doctor about medications that might help with bladder or bowel control.
  4. Consider urotherapy for non-surgical management, like fluid intake and pelvic floor exercises.
  5. Explore intermittent or indwelling catheterization for easier bladder management.
  6. Look into bladder augmentation surgery if the bladder cannot hold enough urine.
  7. Consider Botox® injections to relax bladder muscles and reduce spasms.
  8. Maintain a healthy, fiber-rich diet to manage constipation.
  9. Ensure your child stays hydrated to promote healthy bladder function.
  10. Work with physical therapists to strengthen muscle control and support mobility.

Implementing these strategies can help make incontinence more manageable, improving your child’s day-to-day comfort and confidence.

Innovative Therapies for Cerebral Palsy Incontinence

Recent research by SpineX, a medical technology company specializing in spinal cord treatments, is leading to new treatments for children with cerebral palsy.

Their SCiP™ therapy uses a non-invasive approach to improve muscle control by targeting the root causes of CP. This therapy has already shown promising results, helping children walk and stand more easily.

SpineX is also using this technology to develop treatments for neurogenic bladder, a condition that can affect children with CP.

While it's currently being tested for adults with cerebral palsy and urinary incontinence, this therapy could soon provide better options for children as well, offering hope for managing cerebral palsy incontinence.

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 childbirth.

In these cases, families may be able to pursue legal compensation from the doctors who 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 has cerebral palsy that you think could have been prevented, call us right now at (855) 220-1101 or get a free case review to find out if we may be able to help you seek the money you deserve.

Cerebral Palsy Guide was founded upon the goal of educating families about cerebral palsy, raising awareness, and providing support for children, parents, and caregivers affected by the condition. Our easy-to-use website offers simple, straightforward information that provides families with medical and legal solutions. We are devoted to helping parents and children access the tools they need to live a life full of happiness

  1. Business Wire. (2023, July 27). Leading medtech company Spinex releases groundbreaking results of new cerebral palsy therapies. Retrieved September 26, 2024, from https://www.businesswire.com/news/home/20230727598285/en/Leading-MedTech-Company-SpineX-Releases-Groundbreaking-Results-of-New-Cerebral-Palsy-Therapies
  2. Samijn, B., et al. (2022, August). Incontinence training in children with cerebral palsy: A prospective controlled trial. Journal of Pediatric Urology, 18(4), 447.e1-447.e9. Retrieved September 26, 2024, from https://doi.org/10.1016/j.jpurol.2022.05.014
  3. Vasdev, R., et al. (2021, July 20). Abdominal spasm induced urinary incontinence in a patient with cerebral palsy: The diagnostic utility of urodynamics in neurological disorder management. Cureus, 13(7), e16524. Retrieved September 26, 2024, from https://doi.org/10.7759/cureus.16524