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Urologic aspects of tethered cord
R C Flanigan1, D P Russell, J W Walsh
1Division of Urology, University of Kentucky Medical Center, Lexington.
Urology
|January 1, 1989
Summary
Tethered cord syndrome can cause bladder dysfunction. Urodynamics studies in 24 patients showed most had areflexic bladders, with some improvement after surgery, highlighting the urologist
Area of Science:
- Neurology
- Urology
- Pediatric Surgery
Background:
- Tethered cord syndrome (TCS), a congenital condition, is associated with spinal dysraphism.
- Vesical neurologic dysfunction is a potential complication of TCS.
- Understanding bladder dysfunction in TCS is crucial for patient management.
Purpose of the Study:
- To evaluate the urodynamic findings in patients with tethered cord syndrome.
- To assess the impact of surgical intervention on bladder function in TCS.
- To emphasize the urologist's role in managing TCS-related neuropathic bladders.
Main Methods:
- Retrospective review of 60 tethered cord syndrome cases.
- Preoperative urodynamics studies, including cystometrography, in 24 patients.
- Serial urodynamics testing in 8 patients (pre- and postoperative).
Main Results:
- Preoperative urodynamics revealed areflexic bladders in 71% and hyperreflexic bladders in 29% of patients.
- Postoperative urodynamics showed slight improvement in 4 of 6 areflexic bladders and the single hyperreflexic bladder studied.
- Two of three patients with preoperative urinary symptoms experienced clinical improvement postoperatively.
Conclusions:
- Tethered cord syndrome frequently presents with significant bladder dysfunction.
- Surgical treatment may lead to functional improvement in neuropathic bladders associated with TCS.
- Early detection, evaluation, and management by urologists are vital for patients with TCS and associated bladder issues.