Colonic and anorectal dysfunction in a patient with the tethered cord syndrome

Although visceral dysfunction is commonly encountered in the tethered cord syndrome, alteration of intestinal motor and sensory function has not yet been specifically addressed in this neurological disorder. We report the case of a 54-yr-old woman with a rare form of adult onset tethered cord syndrome who presented to us for preoperative assessment of marked constipation, urinary and fecal incontinence, and a rectal prolapse. It is shown that the tethered cord syndrome causes complex clinical patterns of bowel dysfunction and that careful efforts are mandatory to differentiate their underlying pathology. Specific diagnostic procedures directed to intestinal motility and perception were of decisive importance in enabling us to apply the appropriate treatment to our patient.