The value of sacral skin lesions in predicting occult spinal dysraphism in children with voiding dysfunction and normal neurological examination

TARCAN T., Tinay I., Temiz Y., ALPAY H., Ozek M., Simsek F.

JOURNAL OF PEDIATRIC UROLOGY, cilt.8, sa.1, ss.55-58, 2012 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 8 Sayı: 1
  • Basım Tarihi: 2012
  • Doi Numarası: 10.1016/j.jpurol.2010.11.002
  • Dergi Adı: JOURNAL OF PEDIATRIC UROLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.55-58
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Objective: The role of magnetic resonance imaging (MRI) in detecting occult spinal dysraphism (OSD) in children with voiding dysfunction and a normal neurological examination is still under debate. The aim of this study was to assess the correlation of sacral skin lesions with OSD detected on MRI, in a population of children with resistant lower urinary tract symptoms (LUTS). Patients and methods: A total of 114 children over 5 years of age with urinary tract infection (UTI) and/or LUTS and normal neurological examination were enrolled. All children underwent sacral neurological examination, urine analysis and cultures, renal/bladder ultrasound, voiding cystourethrogram and urodynamic examination. After a treatment period of 6 months, the patients were re-evaluated and spinal MRI was performed in 61 with ongoing LUTS or UTI. Results: Nineteen of 61 children (31%) had cutaneous stigmas. MRI detected spinal abnormality in 2/42 children with a normal sacral examination in comparison to 7/19 children with an abnormal sacral finding (Chi-squared test, P < 0.005). The sensitivity and specificity of an abnormal sacral finding in predicting MRI abnormality were 0.76 and 0.77, respectively. Urodynamic parameters did not predict an abnormal spinal MRI. Conclusions: Abnormal sacral findings, but not urodynamic studies, are strong predictors of OSD. A normal sacral examination does not rule out OSD. (C) 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.