Treatment of persistent enuresis. Results of severing a tight filum terminale

A tight filum terminale was severed in an attempt to treat intractable enuresis in 27 children. Urodynamic studies demonstrated pre-operative bladder instability in all cases. Although symptom scores for enuresis improved significantly 6 months after surgery, only 7 patients benefited clinically (3 were cured and enuresis was reduced in 4). An average of 26 months later, 12 patients were either dry or their enuresis was reduced, probably due to spontaneous cure rather than surgery. We found no clinical parameters able to predict a favourable outcome. It was concluded that although a tight filum terminale is a cause of intractable enuresis, transection of the filum is not recommended because of the low success rate.