Cross-sectional study of urinary problems in adults with cerebral palsy: awareness and impact on the quality of life

We aimed to assess the functional status, urinary problems, and awareness of these problems in adults with cerebral palsy (CP) and their relationship with the quality of life. One-hundred-seventeen adults with CP (53 women, 64 men) were included in this study. Subjects were asked to fill out a urological questionnaire which dealt with urinary symptoms, awareness of urinary problems, and pharmacological treatment they received. Subjects were also assessed with the Gross Motor Function Classification System (GMFCS), Functional Independence Measures (FIM), Functional Mobility Scale (FMS), and King's Health Questionnaire (KHQ). The mean age of the subjects was 25.3 +/- 7.8 years. Of the patients, 83.8% were currently unemployed, 95.7% were single, and 96.5% were living with family. Of the patients, 20.5% had experienced frequency, 38.5% had nocturia, 48.7% had urgency, and 36.8% had urge urinary incontinence. Approximately 80% of the patients did not refer to physician due to urinary problems, and 60% of patients were not recorded history about urinary problem by any physician. Urge urinary incontinence was statistically more frequent in females than males (54.7 and 21.9%,respectively, p < 0.05). Female patients had significantly higher KHQ incontinence impact, role limitation, physical limitation, emotion, incontinence severity measures, and symptom severity subgroup scores than male patients (p < 0.05). Urge urinary incontinence was most frequent (65.4%) in spastic quadriplegic CP (p < 0.05). All functional status scores (GMFCS, FIM-toilet transfer, and FMSs) were worse in spastic quadriplegic patients than other topographical involvement of CP (p < 0.0125). Although the urinary problems are common in adult with CP, it is yet an overlooked condition that could affect quality of life. Therefore, health care professionals, patients, and their caregivers should be aware of the increased risk of urinary problems in these patients.