Management of Cerebral Palsy with Constipation, Urinary Retention, and Recurrent UTIs
Urinary Retention Management
- The British Journal of Sports Medicine recommends using single-use catheters only, as reuse significantly increases UTI frequency, and performing hand hygiene with antibacterial soap or alcohol-based cleaners before and after catheter insertion 1, 2
- The British Journal of Sports Medicine suggests maintaining catheterization schedule every 4-6 hours, keeping urine volume below 500 mL per collection, and considering hydrophilic catheters to reduce UTI and hematuria risk 2, 3
Recurrent UTI Management
- The British Journal of Sports Medicine advises treating only symptomatic UTIs, sending urine for microscopy, culture and sensitivity before initiating antibiotics, and changing indwelling catheter prior to collecting urine sample if present 1, 2, 5, 7
- The British Journal of Sports Medicine recommends maintaining adequate hydration of 2-2.5 L/day, educating on proper hand washing and catheter hygiene techniques, and avoiding routine prescription of antibiotic prophylaxis 1, 5, 8, 9
- The British Journal of Sports Medicine suggests considering antibiotic prophylaxis only if ≥3 symptomatic UTIs per year with positive cultures are chronically impairing function, and using weekly oral cyclic antibiotic (WOCA) regimen alternating antibiotics based on prior culture sensitivities 1, 8
Constipation Management
- The British Journal of Sports Medicine recommends increasing fluid intake to 2-2.5 L/day 1, 5
- The Stroke journal suggests considering prophylactic stool softeners 10