MP53-08 DO URODYNAMIC STUDIES PREDICT SYMPTOMATIC OUTCOMES AFTER SPINAL CORD DE-TETHERING SURGERY?

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP53-08 DO URODYNAMIC STUDIES PREDICT SYMPTOMATIC OUTCOMES AFTER SPINAL CORD DE-TETHERING SURGERY? Emily Reeson and Gwen Grimsby Emily ReesonEmily Reeson More articles by this author and Gwen GrimsbyGwen Grimsby More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003301.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Past studies have no consensus on whether urodynamic studies (UDS) are predictive of continence status after spinal de-tethering surgery. The objectives of this study were to compare UDS results before and after spinal cord de-tethering surgery and to compare UDS results in patients with and without resolution and improvement of urologic symptoms after surgery. METHODS: A retrospective review was performed of children who underwent spinal cord de-tethering surgery at a quaternary children’s hospital from 1/2012 to 1/2020. Age at surgery, gender, and urologic (GU) symptoms (daytime urinary incontinence, nocturnal enuresis, vesicoureteral reflux, UTIs), as well as UDS results were collected. Abnormal UDS was defined as reduction in expected bladder capacity, decreased compliance, or detrusor over-activity. Presence of pre-operative GU symptoms as well as UDS results were compared between patients with and without resolution and improvement of urologic symptoms after surgery via t tests or Chi Square. Pre and post-operative UDS results were also compared. RESULTS: Of the 216 children included, 92 (43%) underwent pre-operative UDS testing. Mean age at surgery was 6.4 years and mean length of follow up 1.9 years. Pre-operative UDS was abnormal in 51 (55%) patients. 35 (38%) had detrusor over activity. Mean end fill pressure was 29 cm H2O. Of the 29 (32%) who also underwent post-operative UDS testing, results improved in 15 of 24 (63%) patients who had an abnormal UDS prior to surgery. Mean time between surgery and post-operative UDS was 0.93 years. Mean end fill pressure decreased from 31 to 18 cm H2O (p=0.0628) and significantly more patients had detrusor over activity before surgery compared with after surgery (52% vs 21%, p=0.0277). 49/92 (53%) patients had pre-operative GU symptoms and 7 (14%) of them had resolution of these symptoms at the time of last follow up. There was no difference in UDS findings between patients with and without improvement or resolution of urologic symptoms after spinal de-tethering, Table 1. CONCLUSIONS: Pre-operative UDS testing did not predict improvement in urologic symptoms after spinal de-tethering surgery. Though 63% of patients had improvement in UDS parameters after spinal surgery, this did not appear to correlate with improvement in urologic symptoms. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e714 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emily Reeson More articles by this author Gwen Grimsby More articles by this author Expand All Advertisement PDF downloadLoading ...