title: Urodynamic findings in the tethered spinal cord: the effect of tethered cord division on lower urinary tract functions.
abstract: OBJECTIVE
  The aim of this study is to evaluate the effect of division of the tethered spinal cord urodynamically in spinal dysraphic cases.
  
  
  METHODS
  Between 1995-1997, 20 cases (11 males, 9 females) aged from 5 months to 13 years with TSC were investigated. 13 cases (65%) were classed as belonging to the myelomeningocele group and 5 cases (35%) to the spina bifida occulta group. We used a computerized urodynamic system to evaluate the functions of the lower urinary tracts pre- and postoperatively. The definitive diagnosis of cord tethering was made using magnetic resonance imaging (MRI) in 19 cases (95%) and spinal ultrasound in 1 case (5%). Division of filum terminale and laminectomy were carried out in all cases by the Neurosurgery Department, and 2 cases with retethering were operated on twice.
  
  
  RESULTS
  All of these cases were assessed urodynamically in the preoperative and postoperative period. Significant improvements were noted in detrusor functions (35%); electromyography recordings (45%); high leak point pressures (55%) and anal and urinary continence (70%).
  
  
  CONCLUSIONS
  Lower urinary tract dysfunctions secondary to tethered cord syndrome are very common in spinal dysraphic cases and significant improvements can be achieved with a judiciously timed division of the spinal tethered cord.
authors.affiliation: Department of Paediatric Surgery, The Medical Faculty of Uludağ University, Bursa, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Balkan
authors.forename: N
authors.initials: N
authors.lastname: Kiliç
authors.forename: I
authors.initials: I
authors.lastname: Avşar
authors.forename: S
authors.initials: S
authors.lastname: Boyaci
authors.forename: K
authors.initials: K
authors.lastname: Aksoy
authors.forename: H
authors.initials: H
authors.lastname: Doğruyol
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008591:Meningomyelocele / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D016136:Spina Bifida Occulta / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D013116:Spinal Cord / Q000601:surgery*; D013118:Spinal Cord Diseases / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D014563:Urodynamics