Neurodevelopmental disorders (NDs) are incapacitating disorders, which begin early in life, are mainly caused by genetic and neurobiological factors, and show a tendency to persist. They are associated with higher rates of incontinence in children and adolescents, including nocturnal enuresis, daytime urinary incontinence, fecal incontinence, and constipation. Without diagnosis and treatment, they will interfere with incontinence treatment leading to less favorable outcomes. The aim of this International Children's Continence Society (ICCS) document is to provide an overview of the three most important NDs, that is, attention-deficit/hyperactivity disorder, autism spectrum disorder (ASD), and intellectual disability (ID).
This consensus paper was commissioned by the ICCS. A selective, nonsystematic review was performed. Guidelines, reviews, and selected studies were included. The recommendations are consensus-based.
ADHD is the most common ND with special relevance in clinical practice. ASD and ID are less common, but more severe disorders than ADHD. Basic principles of the assessment and treatment of NDs are provided. Incontinence is common among patients with NDs. Specific modifications and practical approaches in the treatment of incontinence in children with NDs are outlined.
Incontinence in children and adolescents with NDs is common. Effective treatment of incontinence should be adapted and modified to the specific needs of patients with NDs. A multiprofessional approach is recommended.
Neurourology and urodynamics. 2021 Sep 29 [Epub ahead of print]
Alexander von Gontard, Justine Hussong, Stephen S Yang, Janet Chase, Israel Franco, Anne Wright
Department of Urology, Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands., Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany., Department of Urology, Taipei Tzu Chi Hospital and Buddhist Tzu Chi Universtiy, New Taipei, Taiwan., Victorian Children's Continence Clinic, Melbourne, Victoria, Australia., Children's Bladder and Continence Program, Yale School of Medicine, Yale New Haven Hospital, New Haven, Connecticut, USA., Children's Bladder Clinic, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK.