Urological Problems in Tethered Cord Syndrome

Abstract

Tethered cord syndrome is infrequently seen in out-patient urological department as urological problems do not present as the initial signs or symptoms for this syndrome. The symptom of voiding dysfunction is frequently confused with other causes of urinary incontinence. Due to long-term complications which can result in hemodialysis, early diagnosis of tethered cord syndrome is important. The aim of this study was to investigate the clinical manifestation and severity of tethered cord syndrome. From January 1995 through April 1999, we retrospectively collected the medical records of 5 patients with tethered cord syndrome who had an aver-age age of 30 yrs. They all presented with urological symptoms as the initial call for help. Four patients had predominant symptoms of lower abdominal fullness and pain. Detrusor hyperre-flexia with detrusor-sphincteric dyssynergia were seen in 4 patients. One patient presented with detrusor hyporeflexia and poor compliance as seen on the cystometrogram. Untethering surgeries with removal of lipoma were performed in 4 patients. One patient developed hemodi-alysis during the 1-yr follow-up period. Two patients showed persistent chronic renal insufficiency. Only l patient maintains normal renal function because of early diagnosis and early treatment. This result indicates that prognosis is poor when the diagnosis is delayed. We suggest early diagnosis and early treatment as the preferred way to resolve the problem of progressively worsening renal function. Because only a small number of patients were available, more studies of tethered cord syndrome would be helpful to clarify the clinical presentations of urological problems.