Purpose: To investigate the association between postoperative bladder dysfunction and preoperative/surgical findings on spinal myxopapillary ependymoma (MPE). Methods: The study included eight patients (five males and three females) with an average age of 56.2 years (range: 21-76 years) who underwent tumor resection between 2011 and 2021. The patient history, magnetic resonance imaging findings, intraoperative findings, surgical methods, and postoperative bladder dysfunction were evaluated. The bladder dysfunction was categorized as mild (frequent urination or retarded micturition) and severe (urinary retention or incontinence). Results: The mean postoperative follow-up was 97.3 (42-160) months. Gross total resection (GTR) was performed in six cases, in three cases by en block resection and three cases by piece-by-piece resection. In GTR cases, an en block resection case with intraoperative adhesion to conus and preoperative normal bladder function presented with postoperative severe bladder dysfunction up to one year. A piece-by-piece resection case with intraoperative adhesion to cauda equina and preoperative mild bladder dysfunctiondeteriorated to severe dysfunction postoperatively. Subtotal resection (STR) was performed in two cases, which did not show postoperative bladder dysfunction. There was no recurrence of tumor in the all cases. Conclusions:Surgeons should have in mind that in the case with intraoperative adhesion to conus or cauda equina, performing GTR may lead to deteriorated bladder function postoperatively. Careful detachment and gradual intraoperative neuromonitor are necessary to achieve GTR.
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