The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Incontinence training in children with cerebral palsy: A prospective controlled trial
Abstract
Introduction Urinary incontinence is the most frequently observed lower urinary tract symptom in children with cerebral palsy (CP). Being continent can positively influence quality of life of the child and the social environment.Objective To investigate the effectiveness of incontinence training with urotherapy in children with CP.Study design A population-based case-control study was conducted including 21 children with CP and 24 typically developing children between 5 and 12 years old, both with daytime incontinence or combined daytime incontinence and enuresis. Children received treatment for one year with three-monthly examination by means of uroflowmetry, a structured questionnaire and bladder diaries. Children started with three months of standard urotherapy. After three, six and nine months of training, specific urotherapy interventions (pelvic floor muscle training with biofeedback, alarm treatment or neuromodulation) and/or pharmacotherapy could be added to the initial treatment. Therapy was individualized to probable underlying conditions. Effectiveness was controlled for spontaneous improvement due to maturation and analysed by means of longitudinal linear models, generalized estimating equations and multilevel cumulative odds models. Comparison with typically developing children was assessed by means of Kaplan-Meier survival analysis.Results Results suggest effectivity rate of incontinence training is lower and changes occur more slowly in time in children with CP compared to typically developing children (Figure). Within the group of children with CP, significant changes during one year of training were found for daytime incontinence (p < 0.001), frequency of daytime incontinence (p = 0.002), frequency of enuresis (p = 0.048), storage symptoms (p = 0.011), correct toilet posture (p = 0.034) and fecal incontinence (p = 0.026).Discussion Maximum voided volume and fluid intake at the start of training were significantly lower in children with CP and could explain a delayed effectiveness of urotherapy. Treatment of constipation demonstrated a positive effect on maximum voided volume and should be initiated together with standard urotherapy when constipation is still present after implementation of a correct fluid intake schedule. Future research with a larger sample size is recommended.Conclusions Incontinence training with urotherapy can be an effective treatment for urinary incontinence in children with cerebral palsy. In the current cohort, effectivity rate of incontinence training was lower and changes occurred more slowly in children with cerebral palsy compared to typically developing children.
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“Analysis of data collected at pre- and post-intervention, as well as at 3-month intervals, revealed that incontinence training with urotherapy effectively reduced daytime enuresis, incontinence frequency, and fecal incontinence in children with CP, though these results were slower to occur, and the intervention was overall less effective when compared with the typically developing cohort [46].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [46]
In the citing paper
“Analysis of data collected at pre- and post-intervention, as well as at 3-month intervals, revealed that incontinence training with urotherapy effectively reduced daytime enuresis, incontinence frequency, and fecal incontinence in children with CP, though these results were slower to occur, and the intervention was overall less effective when compared with the typically developing cohort [46].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [46]
In the citing paper
“Analysis of data collected at pre- and post-intervention, as well as at 3-month intervals, revealed that incontinence training with urotherapy effectively reduced daytime enuresis, incontinence frequency, and fecal incontinence in children with CP, though these results were slower to occur, and the intervention was overall less effective when compared with the typically developing cohort [46].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [46]
In the citing paper
“Analysis of data collected at pre- and post-intervention, as well as at 3-month intervals, revealed that incontinence training with urotherapy effectively reduced daytime enuresis, incontinence frequency, and fecal incontinence in children with CP, though these results were slower to occur, and the intervention was overall less effective when compared with the typically developing cohort [46].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [46]
In the citing paper
“Of the seven active intervention studies, all used randomization for allocation to groups [41,42,43,45,46,47,48].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [46]
Citations
Cites
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Self-citationEvaluation and Treatment of Functional Constipation in Infants and Children
Tabbers, M. M., DiLorenzo, C., Berger, M. Y., Faure, C. C., Langendam, M. W., Nurko, S., Staiano, A., Vandenplas, Y., & Benninga, M. A. (2013) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000000266 · Cited by 1,173
Lower urinary tract dysfunction in the neurological patient: clinical assessment and management
Panicker, J. N., Fowler, C. J., & Kessler, T. M. (2015) · The Lancet Neurology · doi:10.1016/s1474-4422(15)00070-8 · Cited by 601
Nock, M. K., & Ferriter, C. (2005) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-005-4753-0 · Cited by 492
The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy
Heinen, F., Desloovere, K., Schroeder, A. S., Berweck, S., Borggraefe, I., Campenhout, A. V., Andersen, G. L., Aydın, R., Becher, J. G., Bernert, G., et al. (2009) · European Journal of Paediatric Neurology · doi:10.1016/j.ejpn.2009.09.005 · Cited by 296
Self-citationChang, S., LAECKE, E. V., Bauer, S. B., et al. (2015) · Neurourology and Urodynamics · doi:10.1002/nau.22911 · Cited by 191
Nieuwhof-Leppink, A. J., Hussong, J., Chase, J. W., et al. (2020) · Journal of Pediatric Urology · doi:10.1016/j.jpurol.2020.11.006 · Cited by 129
Reasons for Hospital Admissions Among Youth and Young Adults With Cerebral Palsy
Young, N. L., McCormick, A., Gilbert, T., Ayling-Campos, A., Burke, T. A., Fehlings, D. L., & Wedge, J. H. (2010) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2010.10.002 · Cited by 104
Urodynamic Assessment of Children With Cerebral Palsy
Decter, R. M., Bauer, S. B., Khoshbin, S., et al. (1987) · The Journal of Urology · doi:10.1016/s0022-5347(17)43518-x · Cited by 89
Lower urinary tract dysfunction in cerebral palsy.
Reid, C. J. D., & Borzyskowski, M. (1993) · Archives of Disease in Childhood · doi:10.1136/adc.68.6.739 · Cited by 81
Cited by
The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research
Rausch, R., Chahin, S., Miller, C., Dopheide, L., Bovio, N., Harris, A., & Patel, D. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14124364 · Cited by 8
Metadata
- Authors
- Samijn, B., Van den Broeck, C., Plasschaert, F., Pascal, A., Deschepper, E., Hoebeke, P., & Van Laecke, E.
- Affiliations
- Ghent University Hospital (BE)
- Ghent University (BE)
- Corresponding author
- Samijn, Bieke
- Plasschaert, Frank
- Pascal, Aurelie
- Deschepper, Ellen
- Hoebeke, Piet
- Venue
- Journal of Pediatric Urology
- Publisher
- Elsevier BV
- Published
- 2022-08
- Volume
- 18
- Issue
- 4
- Pages
- 447.e1-447.e9
- ISSN
- 1477-5131 (ISSN-L)
- OpenAlex
- W4281482951
- Cited by
- 10
- References
- 23
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 2
- FWCI
- 2.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pediatric Urology (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Funders
- Fondation Motrice (2017/6)
- Topics
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Urology and Nephrology Studies
- Health Sciences › Medicine › Rehabilitation › Cerebral Palsy and Movement Disorders
- Keywords
- cerebral palsy, urinary incontinence, urotherapy, children, daytime incontinence, enuresis, pelvic floor muscle training, biofeedback, enuresis alarm, neuromodulation, pharmacotherapy, constipation, voided volume, fluid intake, fecal incontinence, lower urinary tract symptoms, quality of life, treatment effectiveness, bladder diary, uroflowmetry
- MeSH terms
- Cerebral Palsy, Child, Child, Preschool, Constipation, Humans, Prospective Studies, Quality of Life, Urinary Incontinence, Case-Control Studies, Nocturnal Enuresis
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