title: Urodynamic findings in patients with Currarino syndrome.
abstract: OBJECTIVE
  Currarino syndrome is an inherited disorder consisting of a triad of anorectal anomaly, sacrococcygeal defect and presacral mass. We evaluated the urological issues in patients with Currarino syndrome and sought to determine whether spinal cord detethering improves urinary tract function.
  
  
  METHODS
  We retrospectively reviewed 14 patients diagnosed with Currarino syndrome. We evaluated urinary signs/symptoms and urodynamic findings before and after spinal cord detethering.
  
  
  RESULTS
  All patients with Currarino syndrome having a sacral defect and presacral mass were diagnosed between birth and 6 years. Of the patients 86% had a tethered spinal cord that was surgically detethered between 8 months and 6 years (average 3 years). Overall 10 of 12 children who underwent surgery had voiding complaints postoperatively, including urgency, frequency and incontinence. Five patients had recurrent urinary tract infections, of whom 3 had vesicoureteral reflux that resolved spontaneously. Three patients had mild unilateral hydronephrosis without reflux. Ten of 12 patients who underwent spinal cord detethering underwent comprehensive urodynamic evaluation. Of the 5 patients who underwent preoperative and postoperative urodynamic evaluation 3 showed improvement with resolution of detrusor overactivity or dyssynergia postoperatively, and 2 demonstrated no change. Of the 5 patients who underwent only postoperative urodynamic evaluation 4 had abnormal findings, including small capacity, poor compliance, detrusor overactivity, detrusor sphincter dyssynergia and/or high voiding pressure. No progressive denervation was seen on electromyography preoperatively or postoperatively.
  
  
  CONCLUSIONS
  Currarino syndrome is a rare congenital disorder with few published reports regarding the long-term implications. Although no solid conclusions could be drawn regarding urodynamic improvement postoperatively due to our small sample size, spinal cord detethering did not lessen ongoing voiding complaints in the study patients.
authors.affiliation: Department of Urology, Boston University Medical Center, Boston, Massachusetts 02115, USA.
authors.forename: Nora G
authors.initials: NG
authors.lastname: Lee
authors.forename: Renato
authors.initials: R
authors.lastname: Gana
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Borer
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Estrada
authors.forename: Shahram
authors.initials: S
authors.lastname: Khoshbin
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Bauer
mesh_terms: D001003:Anal Canal / Q000002:abnormalities / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004065:Digestive System Abnormalities / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009436:Neural Tube Defects / Q000601:surgery*; D012007:Rectum / Q000002:abnormalities / Q000503:physiopathology; D012189:Retrospective Studies; D012447:Sacrum / Q000002:abnormalities / Q000503:physiopathology; D013595:Syringomyelia / Q000150:complications / Q000503:physiopathology*; D014555:Urination Disorders / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics