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 average
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 hyperreflexia
with detrusor-sphincteric dyssynergia were seen in 4 patients. One patient presented with
detrusor hyporeflexia and poor compliance as seen on the cystometrogram. All patients with
tethered cord syndromes were diagnosed with magnetic resonance imaging (MRI). Untethering
surgeries with removal of lipoma were performed in 4 patients. One patient developed hemodialysis
during the 1-yr follow-up period. Two patients showed persistent chronic renal insufficiency.
Only 1 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.
