Urodynamic outcomes of detethering in children: experience with 46 pediatric patients
Murat Geyik1, Sırma Geyik2, Haluk Şen3
1Department of Neurosurgery, Gaziantep University, Gaziantep, Turkey. drmuratgeyik@gmail.com.
Insights
Surgical detethering improves bladder function in children with tethered cord syndrome (TCS). Older children, particularly those over 10 years, show the most significant urological benefits from this surgery.
Area of Science:
- Pediatric Urology
- Neurosurgery
- Urodynamics
Background:
- Tethered cord syndrome (TCS) frequently causes neurological and urological issues.
- Surgical detethering is the primary treatment for TCS.
- Objective pre- and postoperative evaluations are crucial for assessing urological outcomes in pediatric TCS patients.
Purpose of the Study:
- To evaluate the impact of surgical detethering on urodynamic parameters in children with TCS.
- To determine the correlation between changes in urodynamic tests and patient age and gender.
Main Methods:
- Retrospective analysis of urodynamic test data from 46 pediatric TCS patients.
- Measurement of bladder capacity, post-voiding residual urine volume, maximum intravesical pressure, and bladder compliance before and 3 months after surgery.
- Statistical comparison of parameters and investigation of correlations with age, gender, and TCS etiology.
Main Results:
- Surgery led to decreased bladder capacity and post-voiding residual urine volume.
- Maximum intravesical pressure and bladder compliance increased post-surgery.
- Significant improvements in bladder capacity were observed in patients older than 10 years. Age positively correlated with increased maximum intravesical pressure and negatively with bladder compliance.
Conclusions:
- Surgical detethering significantly impacts bladder capacity, post-voiding residual urine volume, and bladder compliance in TCS patients.
- Children over 10 years of age are most likely to experience urological benefits from TCS surgery.
Aim:
Tethered cord syndrome (TCS) manifests with neurological and urological complaints. Surgical detethering is the main treatment for TCS. Children with urological symptoms are required objective pre- and postoperative evaluations in order to predict urological outcome. The aims of this study are to investigate the effects of detethering procedure on the urodynamic tests and to determine the relationship between the changes of urodynamic tests and the patients' age and gender.
Material And Methods:
The data of urodynamic tests in 46 pediatric patients, who underwent surgery for TCS, were retrospectively evaluated. Bladder capacity, post-voiding residual urine volume, maximum intravesical pressure, and bladder compliance of each patient were measured in preoperative period and at the third month after surgery. These parameters were statistically compared, and the correlations of these parameters with age, gender, and etiology of the TCS were also investigated.
Results:
Bladder capacity and post-voiding residual urine volume were decreased and maximum intravesical pressure and bladder compliance were increased after surgery for TCS. The decrease in bladder capacity was significant in patients older than 10 years (p < 0.05). The increase in maximum intravesical pressure was also positively correlated with age (p < 0.05). But the increase in bladder compliance was negatively correlated with age (p < 0.05).
Conclusion:
Bladder capacity, post-voiding residual urine volume, and bladder compliance are mainly affected by surgery in patients with TCS. From the urological viewpoint, children older than 10 years are most likely to benefit from surgery for TCS.
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