Prognostic factors affecting urologic outcome after untethering surgery for lumbosacral lipoma.
OBJECTIVE
The authors report results of preoperative and postoperative urodynamic studies (UDS) and prognostic factors of urologic outcome in cases of lumbosacral lipomas for which prolonged follow-up data were available.


METHODS
The present series includes 42 consecutive cases of lumbosacral lipoma in patients aged 2 months to 15 years who underwent untethering operation during the period from 1986 to 1997. All of them underwent preoperative and postoperative UDS. At the last follow-up (mean duration of follow-up 108 months, range 44 to 176 months), 26 cases maintained social continence with or without intermittent catheterization. Young age (< or =12 months) at operation, preoperative absence of urologic symptoms, and absence of neurologic abnormalities were significantly correlated with favorable urologic outcome.


CONCLUSIONS
UDS in cases with lumbosacral lipomas is a valuable tool for detecting neurourologic abnormalities as well as for monitoring the postoperative course and guiding management. History taking and neurologic examination are also proved to be important aspects in the evaluation of children with lumbosacral lipomas, predictive of urologic outcome. Better urologic results are anticipated if surgery is performed when the child is 12 months old or younger.
Department of Neurosurgery, Konkuk University Hospital, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-914, South Korea.
Hyun-Seung
HS
Kang
Kyu-Chang
KC
Wang
Kwang Myung
KM
Kim
Seung Ki
SK
Kim
Byung Kyu
BK
Cho
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008067:Lipoma / Q000151:congenital* / Q000601:surgery; D008159:Lumbar Vertebrae; D008297:Male; D009436:Neural Tube Defects / Q000601:surgery*; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000209:etiology*; D012447:Sacrum; D013125:Spinal Neoplasms / Q000151:congenital* / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000209:etiology*; D053201:Urinary Bladder, Overactive / Q000209:etiology; D014549:Urinary Incontinence / Q000209:etiology*; D014563:Urodynamics / Q000502:physiology