Focused non-invasive assessment of lower urinary tract dysfunction among children with cerebral palsy

Objectives: The objective of the study is to evaluate the prevalence and severity of lower urinary tract dysfunction (LUTD) in children with cerebral palsy (CP) through focused non-invasive ultrasound assessments of post-void residual urine (PVR) and average bladder wall thickness (aBWT). Materials and Methods: A prospective cross-sectional study was conducted from June 2023 to May 2024 at a tertiary care center in Northeast India. Forty-one children with CP and 41 age- and sex-matched controls (age range: 4–12 years) were enrolled. LUTD was assessed using the Dysfunctional Voiding Symptom Score (DVSS) questionnaire, and a blinded radiologist performed ultrasound measurements of PVR and aBWT. Statistical analyses were performed using Statistical Package for the Social Sciences version 25.0. Tests included the Student’s t -test, Chi-square test, and Pearson’s correlation coefficient. Results: The mean age of the CP group was 8 ± 3 years. Median DVSS score in the CP group was 12 (interquartile range [IQR] 9–15), significantly higher than the control group (median 4 [IQR 3–6], P < 0.0001). LUTD was more prevalent in the CP group, with 70.7% showing bladder and bowel dysfunction ( P < 0.0001). Mean aBWT was significantly greater in the CP group (2.22 ± 0.67 mm) compared to controls (1.02 ± 0.60 mm), with a mean difference of 1.20 mm (95% confidence interval: 0.94–1.46 mm; P < 0.0001). Median PVR in the CP group was 10 mL (range: 3–48 mL), compared to 6 mL (range: 2–18 mL) in controls. A moderate positive correlation was found between DVSS scores and aBWT (r = 0.617, P < 0.0001). Conclusion: Children with CP demonstrated significantly higher DVSS scores, aBWT, and PVR compared to controls, consistent with increased prevalence and severity of LUTD. The use of focused non-invasive ultrasound and symptom scoring showed good feasibility and acceptability in this population.