Six-Month Postoperative Urodynamic Score: A Potential Predictor of Long-Term Bladder Function after Detethering Surgery in Patients with Tethered Cord Syndrome
- Author(s)
- Sang Woon Kim; Ji Yong Ha; Yong Seung Lee; Hye Young Lee; Young Jae Im; Sang Won Han
- Keimyung Author(s)
- Ha, Ji Yong
- Department
- Dept. of Urology (비뇨의학)
- Journal Title
- Journal of Urology
- Issued Date
- 2014
- Volume
- 192
- Issue
- 1
- Keyword
- neural tube defects; urinary bladder; urodynamics
- Abstract
- Purpose: We evaluated changes in urodynamic parameters of patients with
tethered cord syndrome after detethering surgery and investigated factors
predicting long-term urological outcome based on a previously described urodynamic
scoring system.
Materials and Methods: A total of 148 patients with tethered cord syndrome
underwent detethering surgery at our hospital between January 2005 and
March 2011. Of these patients 44 with preoperative and postoperative urodynamic
data and a minimum followup of 2 years were included. Urodynamic
score was composed of 4 parameters, with the sum ranging from 0 (favorable) to
a maximum score of 17 (unfavorable).
Results: Mean SD age at surgery was 38.0 77.2 months and followup was
57.2 20.6 months. Preoperative symptoms were present in 24 patients. Total
urodynamic score at 6 months postoperatively was higher than preoperatively
(mean SD 5.61 2.71 vs 4.43 3.56, p ¼ 0.033) and remained at a similar
value during followup (5.88 3.89). The 6-month postoperative total urodynamic
score was significantly lower in the 23 patients with favorable urological outcomes
than in those with unfavorable outcomes (3.87 2.02 vs 7.52 1.99,
p <0.001), whereas the preoperative urodynamic scores did not differ between
these groups. The difference in urodynamic scores between favorable and unfavorable
outcome groups became more prominent with time. By regression
analysis the total urodynamic score at 6-month followup was a predictor of
urological symptoms at last followup (OR 2.763, 95% CI 1.514e5.043, p ¼ 0.001).
Conclusions: Six-month postoperative urodynamic scores accurately predicted
the presence of urological symptoms on long-term followup and may be an
important predictor of long-term urological outcomes after detethering surgery.
Key Words: neural tube defects, urinary bladder, urodynamics
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