Sacral agenesis

Five cases of partial or complete agenesis of the sacrum (also called the caudal regression syndrome) diagnosed at the Chaim Sheba Medical :Center are reported. Neurological dysfunction of the bladder was present in all. Two patients were diagnosed at the ages of four months and three years, and had dilated collecting systems and neurological deficits of the upper motor neuron type. In three of the patients, the malformation was recognized later, at the ages of 7 1/2, 11 and 22 years. All three had a normal urinary tract, on examination by intravenous urography, and neurological deficits of the lower motor neuron type. Although no overt reduction of renal function was noted in those of our patients in whom diagnosis was delayed, it appears that early diagnosis and treatment of the neurogenic bladder associated with the caudal regression syndrome may reduce both morbidity and discomfort.