Related Experiment Video
Updated: Jun 7, 2025
Detrusor Underactivity Model in Rats by Conus Medullaris Transection
Published on: August 28, 2020
The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord
Shuai Yang1,2, Zhaokai Zhou1,2, Xingchen Liu3
1Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Henan 450052, China.
Insights
Detethering surgery (DS) for tethered cord syndrome (TCS) did not significantly improve bladder function and may worsen it. Psychological support is crucial for children undergoing DS.
Area of Science:
- Pediatric Surgery
- Urology
- Neuroscience
Background:
- Tethered cord syndrome (TCS) is often treated with detethering surgery (DS).
- Deterioration of bladder function post-DS negatively impacts quality of life in children.
- The effect of DS on bladder function and psychological well-being requires further investigation.
Purpose of the Study:
- To investigate the impact of detethering surgery (DS) on bladder function and quality of life in children with primary tethered cord syndrome (TCS).
Main Methods:
- Retrospective study of 66 children (aged 6-10 years) diagnosed with TCS who underwent DS.
- Comparison of urodynamic parameters, psychological profiles, and lower urinary tract symptoms before and after DS.
- Patients categorized into normal and abnormal groups based on preoperative urodynamics.
Main Results:
- DS showed statistically significant differences in bladder detrusor sphincter synergy and urodynamic score.
- No significant changes were observed in other urodynamic parameters or psychological-behavioral items post-DS.
- Children with preoperative bladder dysfunction showed improvement or no worsening more frequently than those without.
Conclusions:
- Detethering surgery (DS) does not significantly improve pre-existing bladder dysfunction in TCS patients.
- Conservative management with observation may be suitable for non-progressive bladder dysfunction.
- Enhanced psychological counseling is recommended for children with TCS post-DS due to persistent psychological issues.
Purpose:
Currently, detethering surgery (DS) is the modality most extensively utilized to treat primary Tethered cord syndrome (TCS). Disappointingly, some children without bladder impairment showed a deterioration of bladder function after surgery, which critically influences the health-related quality of life. It was hypothesized that the DS might have a significant effect on bladder function and psychology. Therefore, the purpose of this study was to investigate the effect of DS on bladder function and quality of life in children with primary TCS.
Materials And Methods:
A retrospective study of 83 patients aged 6 to 10 years who were diagnosed with TCS and underwent DS between 2022 and 2023. The urodynamic parameters and score, psychological-behavioral profile, and lower urinary tract symptoms were compared before and after DS. Additionally, the patients were divided into the normal group and the abnormal group according to the preoperative urodynamics parameters.
Results:
A total of 66 children fulfilled the criteria, with a mean age at surgery of 89.5 ± 13.7 months. There were statistically significant differences in bladder detrusor sphincter synergy and urodynamic score and no statistically significant difference in the remaining urodynamic parameters and psychological-behavioral items before and after DS. The proportion of bladder dysfunction that improved or did not worsen after surgery was higher in the Abnormal group than in the Normal group. Nevertheless, the detection rate of each psychological behavior abnormality in children with TCS was higher compared with that of normal children, both preoperatively and postoperatively.
Conclusions:
DS could not considerably ameliorate pre-existing bladder dysfunction and patients exhibiting non-progressive bladder dysfunction could be treated conservatively with close observation. TCS plagues patients all the time even if detethering. Psychological counseling for children with TCS should be strengthened after DS.
