title: Improved symptoms and lifestyle more than 20 years after untethering surgery for primary tethered cord syndrome.
abstract: OBJECTIVE
  Evaluation of the long-term effectiveness of untethering surgery on social adaptations to urinary symptoms at the time of the survey.
  
  
  METHODS
  Postoperative analysis of the current activities of daily life implemented as a postal questionnaire survey. Completed questionnaires were returned by 33 of 52 patients with primary tethered cord syndrome (p-TCS) who had undergone untethering surgery more than 20 years ago, including 10 patients with tight filum terminale (TFT) and 23 with cauda equina adhesion syndrome (CEAS).
  
  
  RESULTS
  Long-term follow-up surveys in patients with p-TCS after untethering surgery indicated excellent effects on lower urinary tract symptoms in 9 of 10 patients with TFT, and the progression of symptoms tended to improve or halted in over half of the 23 patients with CEAS. However, one patient with TFT in whom new symptoms of voiding difficulty appeared immediately after surgery and 7 with CEAS showed deterioration of urinary and/or bowel symptoms. Eighteen patients complained of some symptoms caused by lower urinary tract dysfunction after untethering surgery in terms of difficulty in activities of daily life. With the exception of one female p-TCS patient with short stature and low body weight, all data of physical status, as well as educational level, employment, occupational category and marriage statistics were within the normal respective ranges taken from the Japanese census.
  
  
  CONCLUSIONS
  Postoperative long-term follow-up survey in patients with p-TCS indicated significant improvement of urological symptoms. However, 55% of patients had some lower urinary tract dysfunction that affected their activities in daily life.
authors.affiliation: Department of Urology, Shinshu University Hospital, Asahimachi Matumotoshi, Naganoken, Japan. jun.fukui@nifty.com
authors.forename: Junnosuke
authors.initials: J
authors.lastname: Fukui
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Ohotsuka
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Asagai
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007564:Japan; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009436:Neural Tube Defects / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014554:Urination; D014555:Urination Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D055815:Young Adult