Medical treatment is needed if there is insufficient control over muscles that keep the bladder and/or bowel closed. Includes exercises, biofeedback, drugs, surgery, special undergarments, and surgically implanted devices to aid or replace muscles (sacral neuromodulation is a more recently developed treatment). It is normal for toilet training to go on longer for a child with cerebral palsy, but if they still do not have control from about age 8 or 9 years, other approaches might be considered.
Continence Foundation, tel: 0845 345 0165, www.continence-foundation.org.uk (support, information)
Incontact – Action on Incontinence, tel: 0870 770 3246, www.incontact.org (local groups and helplines)
Thackraycare: Unit 2, Landmark Court, Elland Road, Leeds, LS11 8JT, tel: 0800 590916 (advisory and fitting service for NHS surgical appliances)
Specifically for children
ERIC (Education and Resources for Improving Childhood Continence), tel: 0845 370 8008, www.eric.org.uk (helpline, catalogue of incontinence products, literature)
Half PINNT, tel: 01582 765238, www.pinnt.co.uk (charity providing advice for parents of children on tube, intravenous or nasogastric feeding)
National Advisory Service to Parents of Children with a Stoma (NASPCS), tel: 01560 322024, www.naspcs.co.uk (information, advice and parent-to-parent contact)
Singh BK et al. Levels of continence in children with cerebral palsy. Paediatric Nursing 2006 May;18(4):23-6.
Roth TM. Sacral neuromodulation and lower urinary tract dysfunction in cerebral palsy. International Urogynecological Journal and Pelvic Floor Dysfunction 2007 May;18(5):567-9.
