Bladder dysfunction secondary to tethered cord syndrome in adults: is it curable?

The urological aspects of the tethered cord syndrome were investigated in 15 adults. Impaired detrusor contractility was the most common among the urological symptoms and signs (73 per cent of the patients). Bladder dysfunction was confirmed urodynamically in 93 per cent of the patients and detrusor areflexia was predominant in 60 per cent. Pathological grades were proposed to classify the severity of the tethered cord syndrome. While restoration of bladder function was satisfactory in 67 per cent of the patients postoperatively, the over-all result was less (60 per cent). Patients with sensory motor paralysis of the bladder, symptoms more than 3 years in duration, cutaneous stigmas or a high pathological grade of the syndrome will not benefit from an operation. We conclude that neurogenic bladder secondary to the tethered cord syndrome is curable provided that the underlying pathological condition is recognized properly and an operation is performed early.