Geyik Murat, Geyik Sırma, Şen Haluk, Pusat Serhat, Alptekin Mehmet, Yılmaz Ali Erdem, Nazik Mert, Erkutlu İbrahim
Department of Neurosurgery, Gaziantep University, Gaziantep, Turkey.
Department of Neurology, Gaziantep University, Gaziantep, Turkey.
Childs Nerv Syst. 2016 Jun;32(6):1079-84. doi: 10.1007/s00381-016-3053-y. Epub 2016 Mar 11.
Tethered cord syndrome (TCS) manifests with neurological and urological complaints. Surgical detethering is the main treatment for TCS. Children with urological symptoms are required objective pre- and postoperative evaluations in order to predict urological outcome. The aims of this study are to investigate the effects of detethering procedure on the urodynamic tests and to determine the relationship between the changes of urodynamic tests and the patients' age and gender.
The data of urodynamic tests in 46 pediatric patients, who underwent surgery for TCS, were retrospectively evaluated. Bladder capacity, post-voiding residual urine volume, maximum intravesical pressure, and bladder compliance of each patient were measured in preoperative period and at the third month after surgery. These parameters were statistically compared, and the correlations of these parameters with age, gender, and etiology of the TCS were also investigated.
Bladder capacity and post-voiding residual urine volume were decreased and maximum intravesical pressure and bladder compliance were increased after surgery for TCS. The decrease in bladder capacity was significant in patients older than 10 years (p < 0.05). The increase in maximum intravesical pressure was also positively correlated with age (p < 0.05). But the increase in bladder compliance was negatively correlated with age (p < 0.05).
Bladder capacity, post-voiding residual urine volume, and bladder compliance are mainly affected by surgery in patients with TCS. From the urological viewpoint, children older than 10 years are most likely to benefit from surgery for TCS.
脊髓栓系综合征（TCS）表现为神经和泌尿系统症状。手术松解栓系是TCS的主要治疗方法。有泌尿系统症状的儿童需要进行客观的术前和术后评估，以预测泌尿系统预后。本研究的目的是探讨松解栓系手术对尿动力学检查的影响，并确定尿动力学检查变化与患者年龄和性别的关系。
回顾性评估46例接受TCS手术的儿科患者的尿动力学检查数据。在术前和术后第三个月测量每位患者的膀胱容量、排尿后残余尿量、最大膀胱内压和膀胱顺应性。对这些参数进行统计学比较，并研究这些参数与年龄、性别和TCS病因的相关性。
TCS手术后膀胱容量和排尿后残余尿量减少，最大膀胱内压和膀胱顺应性增加。10岁以上患者的膀胱容量减少显著（p<0.05）。最大膀胱内压的增加也与年龄呈正相关（p<0.05）。但膀胱顺应性的增加与年龄呈负相关（p<0.05）。
TCS患者的膀胱容量、排尿后残余尿量和膀胱顺应性主要受手术影响。从泌尿系统角度来看，10岁以上儿童最有可能从TCS手术中获益。
