Abstract
We investigated fifteen patients with partial sacral agenesis who complained of urological disorders. Those with a myelomeningocele were not included. The mean age at the first visit was 13 years old. Bilateral and unilateral sacral agenesis were observed in nine and six patients, respectively. Chief complaints comprised incontinence and/or nocturnal enuresis in 10 patients, pollakisuria 5, recurrent fever attack due to urinary tract infection 5 and difficulty in micturition 2. In 4 cases vesicoureteral reflux was observed.
At an initial urodynamic study bladder compliance varied from 1.4 to 37.0 (mena 10.4)ml/cmH2O and uninhibited contractions were present in 10 of them. Three patients were judged to have normal or almost normal bladder function. After treatment with clean intermittent catheterization and/or anticholinergics, compliance improved to a mean of 15.1ml/cmH2O and the uninhibited contraction decreased in its amplitude or disappeared completely in 8 of 10 cases. It was suggested that patients with partial sacral agenesis originally suffered from a lower motor neuron lesion. The severity of the sacral deformities and other neurological symptoms (gait or sensory disturbance) were not related with the urodynamic findings. However, it was found that the more the cystogram was deformed the lower was the bladder compliance.
