Lower urinary tract dysfunction in children with benign sacrococcygeal teratoma.
We evaluated 8 girls and 3 boys with benign sacrococcygeal teratoma for lower urinary tract dysfunction. All children underwent ultrasonography of the urinary tract, voiding cystourethrography and at least 2 standard urodynamic evaluations. Mean patient age at first urodynamic study was 59 months (range 1 to 136). Nine of the 11 children had abnormal studies, including detrusor instability and associated pelvic floor overactivity during micturition in 2, an anatomical infravesical obstruction in 2 and neurogenic bladder-sphincter dysfunction in 5 (2 detrusor hyperreflexia with sphincter dyssynergia, 2 hyporeflexic bladder-sphincter function and 1 detrusor hyporeflexia with normal sphincter function). Although the major cause of neurogenic lower urinary tract dysfunction seems to be related to surgical trauma of the pelvic plexus and sacral nerves, we observed tethered spinal cord as a primary cause in 2 patients. The incidence of voiding dysfunction in children with sacrococcygeal teratoma is high and is usually neurogenic in origin.
Boemers
T M
TM
Department of Pediatric Urology, Wilhelmina Children's Hospital, University Hospital for Children and Youth, Utrecht, The Netherlands.
van Gool
J D
JD
de Jong
T P
TP
Bax
K M
KM
D000008:Abdominal Neoplasms / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012445:Sacrococcygeal Region; D013724:Teratoma / Q000150:complications / Q000503:physiopathology*; D014521:Urethra / Q000503:physiopathology*; D014522:Urethral Diseases / Q000209:etiology / Q000503:physiopathology*; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology*; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000503:physiopathology*; D014563:Urodynamics