[A case of neurogenic bladder caused by spinal cord traction in childhood. Diagnostic and therapeutic aspects].
The diagnostic and therapeutic aspects of a pediatric case of tethered cord syndrome are described. The urological symptoms were of primary importance; bladder dysfunction was confirmed urodynamically; voiding cystourethrography showed trabeculation and elongation of bladder with distal sphincter obstruction and left vesicoureteral reflux. The bladder dysfunction was managed satisfactorily with pharmacological therapy and clean intermittent self-catheterization. Nuclear magnetic resonance demonstrated a tethered spinal cord with lipoma of cauda equina. The importance of neuroradiology is emphasized in order to establish an early and precise diagnosis. Early neurosurgery is justified by the need to avoid any progressive and severe lower extremity deficit and by the high frequency of urological improvement in cases treated with spinal operation. However, in this case, clinical and pathological findings suggested to defer any surgical intervention.
Martino
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Divisione di Chirurgia Pediatrica, Ospedale del Bambini G. Salesi, Ancona, Italia.
Lomiento
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D002648:Child; D006801:Humans; D008067:Lipoma / Q000150:complications; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D016136:Spina Bifida Occulta / Q000150:complications* / Q000175:diagnosis; D013120:Spinal Cord Neoplasms / Q000150:complications; D001750:Urinary Bladder, Neurogenic / Q000209:etiology*
Un caso di neurovescica da trazione midollare in età pediatrica. Aspetti diagnostici e terapeutici.