Bowel and bladder management in children with disabilities

Abstract 

Faecal and urinary incontinence are both common in children with additional special needs. Each child is an individual and their continence cannot be considered in isolation from their other problems. Developmental delay and other difficulties as in dyspraxia and attention-deficit disorder interfere with the child's recognition of the need to pass stool or urine. Constipation is common and may present as overflow soiling or wetting. Neuropathic bowel and bladder, as found in spina bifida and spinal cord defects, may be present. These children must be recognized and investigated appropriately in order to identify those where preservation of the upper renal tract function is a priority. In these children, full continence may not be possible but medical and surgical techniques are described which may allow social continence and greater independence. Whatever the cause, continence should always be assessed and managed alongside the child's other difficulties. The social and emotional effects of incontinence should not be underestimated and it should not, by itself, result in educational disadvantage.

Keywords: bladder, neuropathic, bowel, child, disability, incontinence, special needs

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• f1 Correspondence to: KP. E-mail: k.j.price@sheffch-tr.trent.nhs.uk