Urodynamic findings in the tethered spinal cord: the effect of tethered cord division on lower urinary tract functions.
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.
Balkan
E
E
Department of Paediatric Surgery, The Medical Faculty of Uludağ University, Bursa, Turkey.
Kiliç
N
N
Avşar
I
I
Boyaci
S
S
Aksoy
K
K
Doğruyol
H
H
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