Predictive value of intraoperative bulbocavernosus reflex during untethering surgery for post-operative voiding...

Area of Science:

• Pediatric Urology
• Neuroscience
• Surgical Innovation

Background:

• Untethering surgery is performed for spinal cord conditions.
• Predicting post-operative voiding function is crucial for patient outcomes.
• Intraoperative monitoring can offer predictive insights.

Purpose of the Study:

• To assess the clinical significance of intraoperative bulbocavernosus reflex (BCR) during untethering surgery.
• To determine BCR's predictive value for post-operative voiding function.

Main Methods:

• Retrospective review of 106 pediatric patients undergoing untethering surgery.
• Classification of intraoperative BCR response (loss or maintenance).
• Assessment of post-operative voiding function using history, PVR, and UDS.

Main Results:

• BCR was lost in 15 patients; 14 experienced worsened voiding function.
• Intraoperative BCR showed 88.5% specificity in predicting post-operative voiding function at 6 months.
• Specificity increased to 93.4% in patients without lipomyelomeningocele (LMMC).

Conclusions:

• Intraoperative BCR is a valuable predictor of post-operative bladder function after untethering surgery.
• Preservation of intraoperative BCR suggests no deterioration in voiding function.
• The predictive value is particularly high in patients without LMMC.