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ICCS S5-8
(P)
PREOPERATIVE AND POSTOPERATIVE URODYNAMIC OUTCOME OF TETHERED
CORD SYNDROME IN CHILDREN
S. Kerem OZEL
1
, Ibrahim ALATAS
2
, Tuba TUNC
3
, Huseyin CANAZ
2
and Serhat BAYDIN
4
1) Istanbul Bilim University Spina Bifida Research Center, Paediatric Urology, Istanbul, TURKEY - 2) Istanbul Bilim
University Spina Bifida Research Center, Paediatric Neurosurgery, Istanbul, TURKEY - 3) Darica State Hospital,
Neonatology, Izmit, TURKEY - 4) Istanbul Kanuni Sultan Suleyman State Hospital, Neurosurgery, Istanbul, TURKEY
PURPOSE
Tethered cord syndrome (TCS) should be treated in children to avoid motor dysfunction in lower extremities and
neurourological disabilities. The aim of this study was to evaluate the urodynamic outcome of children with TCS before
and after cord release operation.
MATERIAL AND METHODS
Urodynamic reports of all patients with neuropathic bladder dysfunction with TCS were evaluated, retrospectively.
Urodynamic studies were done before and 3 months after tethered cord release in these patients. Patients who had both
preoperative and postoperative test results were enrolled. Age, gender, postvoid residual urine, leak point/voiding
pressures, bladder capacities, detrusor and sphincter activities were noted. Numeric data were evaluated using Wilcoxon
signed ranks test and nominal values with chi square test.
RESULTS
Among a total of 511 urodynamic studies for neuropathic bladder dysfunction, 200 of them that were done for tethered
cord syndrome were evaluated. There were 141 studies for preoperative patients and 59 for postoperative cases. Only
22 patients met the inclusion criteria for whom preoperative and postoperative studies were completed in our institution.
There were 16 females and 6 males with a mean age of 17,8±28 months. Postvoid residual urine increased from
10,5±30,4 ml preoperatively to 15,2±33,4 ml postoperatively (p=0,058). Bladder capacities increased from 62,6±77,5
ml preoperatively to 86,50±81,3 ml postoperatively (p=0,024). Detrusor activity improved in 8 of 22 patients (36%)
and remained unchanged in the rest . All other comparisons were found to be statistically insignificant.
CONCLUSIONS
When done with correct timing tethered cord release may improve bladder function. Although the interpretation of
detrusor activity may not change, it significantly increases bladder capacity and postvoid residual urine which indicates
the relaxation of detrusor in general. Urodynamic studies should be used for indication and follow-up of these children.