Paweł Kroll, Krzysztof Strzyżewski, Andrzej Jankowski
- Katedra Chirurgii Dziecięcej, Klinika Chirurgii i Traumatologii Dziecięcej AM w Poznaniu
- Objectives. Analysis of neuro-urologic symptoms in children with tethered cord syndrome.
- Materials and methods. The study comprised 42 children with tethered cord syndrome operated in our institution. 19 of them were boys, 23 girls, in age from 1 to 15 years. 12 of them had previously operated myelomeningocele, 13 lumbo-sacral lipoma, dysontogenetic tumor in 1 child, diplomyelia in 4, occult spinal dysraphism in 12. In all of them neuro-urologic examination with urodynamic investigations, x-rays of lumbo-sacral region and NMR-scans were performed.
- Results. All children were operated because tethered cord syndrome had influence on symptoms of voiding or storage dysfunction. In cases of myelomeningocele children were previously managed because of known neurogenic bladder-sphincters dysfunction. In 12 cases neuro-urologic symptoms were the cause of further diagnostic procedures. From this group: 7 children were referred to our institution with secondary nocturnal enuresis, 5 with intractable OAB (overactive bladder syndrome). 6 of them had urge incontinence, 7 of them had also a history of recurrent urinary tract infections. In all of them pathology was found in urodynamic investigations. Further evaluation revealed anatomic pathology, spinal cord malformations, leading to surgery.
- Conclusions. Neuro-urologic symptoms could be the first symptoms of tethered cord syndrome. A child with secondary nocturnal enuresis or secondary incontinence should be evaluated with the suspicion of neurogenic bladder dysfunction.