Individuals with cerebral palsy may be affected by motor, sensory, behavioral and/or autonomic dysfunctions. Among the autonomic dysfunctions, those that affect the urinary tract are very prevalent, with emphasis on the neurogenic bladder. Neurogenic bladder reflects findings of loss of inhibition of detrusor hyperactivity, generating voiding dysfunctions. Such dysfunctions are very frequent; however, their characteristics and approaches have been little systematized in the literature.

To present the evidence from the literature that characterize voiding dysfunctions associated with cerebral palsy and the therapeutic approach.

A systematic review was performed following PRISMA recommendations with the research question structured according to population, intervention, control, and outcome. Two reviewers independently performed searches using the descriptors cerebral palsy' and 'neurogenic urinary bladder' in Portuguese, Spanish and English in Bireme (Lilacs, Medline, Scielo), Cinahl, Cochrane, Pubmed and Web databases of Science, no filters. Only published studies were included that included a sample of individuals diagnosed with cerebral palsy, with data on functional characteristics of the urinary tract and/or treatment. Studies that presented individuals with cerebral palsy and other associated diagnoses and studies with the design of reviews, letters or in the protocol phase were excluded.

1314 studies were found and 14 were selected (7 cross-sectional studies and 7 cohort studies). The total sample consisted of 1121 individuals with a mean age of 13.12 ± 8.91 years. The classification showed spastic quadriplegia (n=213), spastic diplegia (n=163), spastic hemiplegia (n=86) and 4 studies did not include classifications. The studies showed as main urinary tract symptoms urge incontinence (64.28%), daytime urinary incontinence (57.14%), stress urinary incontinence (35.71%), enuresis (35.71%), infection urinary tract (28.57%). There was also evidence of a reduction in urinary frequency, voiding fullness, voiding effort, voiding unpredictability, reduction of tension and force of voiding jet, inconstant jet. The therapeutic approach was always linked to the use of medication.

Voiding disorders in individuals with cerebral palsy are characterized by the association of symptoms related to failures in filling and/or emptying the bladder and have been therapeutically addressed only from a symptomatic point of view.

From a scientific point of view, considering the frequency of urinary dysfunctions, this review presents the urgent need to carry out studies with good methodological parameters that involve evaluation and, above all, other forms of treatment, such as, for example, pelvic physiotherapy. From a clinical point of view, this study directs the evaluative practice to conditions of hyperactivity of the detrusor musculature.