Tethered cord syndrome in adolescents: Report of two cases and review of literature
A case of overflow incontinence in an 18-year-old girl was referred from the Department of Urology. She was having a progressively increasing right gluteal swelling with the urinary frequency and urgency for last 5 years. On examination, she had decreased power around the ankle with absent reflex. Her sensation of pain and touch was lost in lateral side of foot with saddle type of perianal anesthesia. Local examination revealed a large non tender, soft, cystic, globular, fluctuating mass of size about 15 cm × 15 cm over her right gluteal area with positive impulse on coughing []. Lumbosacral bony defect was evident in X-ray spine []. Magnetic resonance imaging (MRI) of the lumbo-sacral spine demonstrated meningocele with pulled out tuft of cord from S1 level exiting through right inferior sacral dysraphic defect causing tethered cord []. Incidental finding was bilateral hydronephrosis []. Urodynamic study revealed neurogenic bladder with non-functioning internal sphincter and under active detrusor contractility. Following meningocele repair and untethering of the cord, she had marked neurological improvement with delayed return of urological function.