A case of undiagnosed tethered cord syndrome aggravated by transurethral prostate resection.
BACKGROUND
A 68-year-old man presented with a history of significant urinary urge incontinence, pollakiuria, and weak bladder sensation. He also reported mild fecal incontinence and a hypotrophic and slightly weaker left leg. At 63 years of age he had presented to a urologist for treatment of irritative lower urinary tract symptoms and incontinence. A transurethral resection of the prostate had been performed. After the operation, the symptoms had persisted and the incontinence seriously worsened.


METHODS
Clinical neurologic examination, videourodynamic examination, neurophysiologic examination, and MRI of the spinal cord.


METHODS
Neurogenic bladder dysfunction caused by adult tethered cord syndrome with myelon up to S2 level, spina bifida occulta, and lipoma infiltrating the conus medullaris.


RESULTS
Conservative anticholinergic treatment failed, and injection of botulinum-A toxin is planned.
Balgrist University Hospital, Swiss Paraplegic Center, Zürich, Switzerland. sboy@paralab.balgrist.ch
Sönke
S
Boy
André
A
Reitz
Armin
A
Curt
Brigitte
B
Schurch
D000368:Aged; D000465:Algorithms; D006801:Humans; D008297:Male; D009436:Neural Tube Defects / Q000150:complications* / Q000175:diagnosis; D012720:Severity of Illness Index; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology*