Urodynamic findings in tethered cord syndrome after surgery and its clinical significance / 中华泌尿外科杂志

ABSTRACT

40 cm H 2O (1 cm H 2O=0.098 kPa) in 4.Among the 5 children without urinary complaints,2 had detrusor hyperreflexia,2 had detrusor-sphincter dyssynergia,and 1 was generally normal.Postoperatively the improvement of urinary incontinence rate was greater in patients with primary TCS (28.6%,8/28) than those with secondary TCS (0%,0/7;P=0.048). It was greater in patients with non-lipoma TCS (100%,3/3) than those with lipoma TCS ( 15.6%,5/32;P=0.004).It was greater in patients with meningocele TCS (36.4%,8/22) than those with myelomeningocele TCS(0%,0/6;P=0.047).It was greater in patients born without urological symptoms (80%,4/5) than those born with urological symptoms(17.4%,4/23;P=0.019).Urodynamic studies also showed the incidence of detrusor hyperreflexia after surgery was lower in primary TCS (24.2%,8/32) than in secondary TCS(71.4%,5/7;P=0.015);the incidence of detrusor underactivity was lower in non-lipoma TCS (12.5%,1/8) than in lipoma TCS(56.3%,18/32;P=0.027);decreased compliance rate was lower in meningocele TCS than in myelomeningocele TCS(100%,6/6;P=0.0052).The rates of detrusor hyperreflexia,decreased compliance and detrusor underactivity postoperatively were lower in those born without urinary symptoms (0,0/10;20%,2/10;20%,2/10) than in those with (34.89%,8/23;60.9%,14/23; 65.2%,15/23;P=0.032,P=0.031,P=0.017, respectively). Conclusions Urodynamic examinations are effective in evaluating the lower urinary tract function in children with TCS after surgery.Patients with TCS have various abnormal urodynamic findings.Pathological types of TCS and the presence of symptoms at birth influence urinary function after surgery.