Format

Send to

Choose Destination
J Pediatr Urol. 2012 Feb;8(1):55-8. doi: 10.1016/j.jpurol.2010.11.002. Epub 2010 Nov 26.

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

Author information

1
Department of Urology, Division of Pediatric Urology, Marmara University School of Medicine, Marmara University Hospital, Tophanelioglu Cd. 13-15 Altunizade 34662, Istanbul, Turkey. tufan@marmara.edu.tr

Abstract

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.

PMID:
21112255
DOI:
10.1016/j.jpurol.2010.11.002
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center