Urodynamics findings pre‐ and post‐untethering surgery in children with filum lipoma: A single‐institution experience

Abstract

We aimed to investigate the changes in urodynamics and voiding cystourethrogram parameters on pre-and post-untethering surgery in patients aged under 2 years with filum lipoma. Methods: Sixty-two patients were enrolled in this study. The changes in urodynamics and voiding cystourethrogram parameters were compared before untethering surgery and 6 months after untethering surgery. These parameters were bladder volume, bladder deformity, vesicoureteral reflux during voiding cystourethrogram, detrusor overactivity, bladder compliance, and post-void residual volume in urodynamics. Results: Bladder volume during voiding cystourethrogram and bladder compliance increased significantly from 89.8 AE 49.5 mL to 114.5 AE 50.5 mL (P = 0.0069) and 10.2 AE 6.2 mL/mmH 2 O to 17.0 AE 13.3 mL/mmH 2 O (P = 0.0008), respectively, at 6-month follow-up. Six patients required combination management with clean intermittent catheterization at 25.1 AE 8.2 months (14.3 AE 6.5-months follow-up) because of elevated post-void residual volumes. Conclusions: According to voiding cystourethrogram results, bladder function and urodynamics in patients with filum lipoma significantly improved after untethering surgery. Non-invasive assessment based on measurements of post-void residual should be considered as a postoperative follow-up method.

Editorial Comment to Urodynamics findings pre‐ and post‐untethering surgery in children with filum lipoma: A single‐institution experience

“…Surprisingly, 68% had abnormal urodynamics findings despite of the existence of normal conus. 2 This study reminds us of the importance of urodynamics study during follow-up in all patients with filum lipoma.…”

“…4 The present study reports that urological parameters, particularly bladder capacity and compliance, improved significantly after filum section in filum lipoma with or without TCS at the average age of 14.1 months. 2 Taken in conjunction with prior studies, this would suggest that early surgical intervention may be beneficial in long-term urological function in filum lipoma associated with TCS or occult TCS.…”

“…Morizawa et al report that 32 patients (52%) had abnormal urodynamics findings among 62 patients aged under 2 years with filum lipoma. Surprisingly, 68% had abnormal urodynamics findings despite of the existence of normal conus 2 . This study reminds us of the importance of urodynamics study during follow‐up in all patients with filum lipoma.…”