ABSTRACT
The neurologic dysfunction with Tethered cord syndrome (TCS) can be attributed to lumbosacral cord lesions and is reversible if cord-untethering surgery is done at an appropriate time. This chapter seeks to increase urologists’ understanding of TCS and the importance of early diagnosis and treatment in patients with associated urinary incontinence. Patients with TCS usually show hypoactive tendon reflexes in the lower limbs, because the lesions are located in the gray matter and the reflex arcs are inactivated. Storage and emptying are the two fundamental functions in the human lower urinary tract. These are voluntarily controlled by the cerebral centers and by reflex coordination of the spinal cord centers through the parasympathetic and sympathetic systems, which regulate bladder and sphincter contraction. The baseline bladder function of patients who develop TCS is often abnormal, and a significant number of patients who do not respond to untethering surgery will have residual neurogenic bladder dysfunction.
