The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome
ABSTRACT Purpose: Currently, detethering surgery (DS) is the modality most extensively utilized to treat primary tethered cord syndrome (TCS). Disappointingly, some children without bladder impairment showed a deterioration of bladder function after surgery, which critically influences the health-r...
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Sociedade Brasileira de Urologia
2025-01-01
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| Series: | International Brazilian Journal of Urology |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000100400&lng=en&tlng=en |
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| author | Shuai Yang Zhaokai Zhou Xingchen Liu Zhan Wang Yanping Zhang He Zhang Lei Lv Yibo Wen Qingwei Wang Wei Jia Jinhua Hu Jian Guo Wen |
| author_facet | Shuai Yang Zhaokai Zhou Xingchen Liu Zhan Wang Yanping Zhang He Zhang Lei Lv Yibo Wen Qingwei Wang Wei Jia Jinhua Hu Jian Guo Wen |
| author_sort | Shuai Yang |
| collection | DOAJ |
| description | ABSTRACT Purpose: Currently, detethering surgery (DS) is the modality most extensively utilized to treat primary tethered cord syndrome (TCS). Disappointingly, some children without bladder impairment showed a deterioration of bladder function after surgery, which critically influences the health-related quality of life. It was hypothesized that the DS might have a significant effect on bladder function and psychology. Therefore, the purpose of this study was to investigate the effect of DS on bladder function and quality of life in children with primary TCS. Materials and Methods: A retrospective study of 83 patients aged 6 to 10 years who were diagnosed with TCS and underwent DS between 2022 and 2023. The urodynamic parameters and score, psychological-behavioral profile, and lower urinary tract symptoms were compared before and after DS. Additionally, the patients were divided into the normal group and the abnormal group according to the preoperative urodynamics parameters. Results: A total of 66 children fulfilled the criteria, with a mean age at surgery of 89.5 ± 13.7 months. There were statistically significant differences in bladder detrusor sphincter synergy and urodynamic score and no statistically significant difference in the remaining urodynamic parameters and psychological-behavioral items before and after DS. The proportion of bladder dysfunction that improved or did not worsen after surgery was higher in the Abnormal group than in the Normal group. Nevertheless, the detection rate of each psychological behavior abnormality in children with TCS was higher compared with that of normal children, both preoperatively and postoperatively. Conclusions: DS could not considerably ameliorate pre-existing bladder dysfunction and patients exhibiting non-progressive bladder dysfunction could be treated conservatively with close observation. TCS plagues patients all the time even if detethering. Psychological counseling for children with TCS should be strengthened after DS. |
| format | Article |
| id | doaj-art-d8ac6f07e8114c9da3fac2ad1d80b799 |
| institution | Kabale University |
| issn | 1677-6119 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj-art-d8ac6f07e8114c9da3fac2ad1d80b7992025-02-04T07:37:20ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192025-01-0151110.1590/s1677-5538.ibju.2024.0311The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord SyndromeShuai Yanghttps://orcid.org/0009-0000-7271-4182Zhaokai ZhouXingchen LiuZhan WangYanping ZhangHe ZhangLei LvYibo WenQingwei WangWei JiaJinhua HuJian Guo WenABSTRACT Purpose: Currently, detethering surgery (DS) is the modality most extensively utilized to treat primary tethered cord syndrome (TCS). Disappointingly, some children without bladder impairment showed a deterioration of bladder function after surgery, which critically influences the health-related quality of life. It was hypothesized that the DS might have a significant effect on bladder function and psychology. Therefore, the purpose of this study was to investigate the effect of DS on bladder function and quality of life in children with primary TCS. Materials and Methods: A retrospective study of 83 patients aged 6 to 10 years who were diagnosed with TCS and underwent DS between 2022 and 2023. The urodynamic parameters and score, psychological-behavioral profile, and lower urinary tract symptoms were compared before and after DS. Additionally, the patients were divided into the normal group and the abnormal group according to the preoperative urodynamics parameters. Results: A total of 66 children fulfilled the criteria, with a mean age at surgery of 89.5 ± 13.7 months. There were statistically significant differences in bladder detrusor sphincter synergy and urodynamic score and no statistically significant difference in the remaining urodynamic parameters and psychological-behavioral items before and after DS. The proportion of bladder dysfunction that improved or did not worsen after surgery was higher in the Abnormal group than in the Normal group. Nevertheless, the detection rate of each psychological behavior abnormality in children with TCS was higher compared with that of normal children, both preoperatively and postoperatively. Conclusions: DS could not considerably ameliorate pre-existing bladder dysfunction and patients exhibiting non-progressive bladder dysfunction could be treated conservatively with close observation. TCS plagues patients all the time even if detethering. Psychological counseling for children with TCS should be strengthened after DS.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000100400&lng=en&tlng=enNeural Tube DefectsUrodynamicsPsychologyUrinary BladderNeurogenic |
| spellingShingle | Shuai Yang Zhaokai Zhou Xingchen Liu Zhan Wang Yanping Zhang He Zhang Lei Lv Yibo Wen Qingwei Wang Wei Jia Jinhua Hu Jian Guo Wen The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome International Brazilian Journal of Urology Neural Tube Defects Urodynamics Psychology Urinary Bladder Neurogenic |
| title | The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome |
| title_full | The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome |
| title_fullStr | The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome |
| title_full_unstemmed | The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome |
| title_short | The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome |
| title_sort | effect of detethering surgery on the bladder function and psychology of children with primary tethered cord syndrome |
| topic | Neural Tube Defects Urodynamics Psychology Urinary Bladder Neurogenic |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000100400&lng=en&tlng=en |
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