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Somatosensory evoked potentials as a screening tool for diagnosis of spinal pathologies in children with treatment refractory overactive bladder

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Abstract

Purpose

To evaluate the usefulness of somatosensory evoked potential as a screening tool for spinal pathologies in patients with treatment refractory overactive bladder.

Methods

This prospective study was performed between January 2011 and January 2014. Children >5 years old with treatment refractory overactive bladder were enrolled after exclusion of anatomical and neurological causes of incontinence. All patients underwent urodynamic studies, spinal MRI, and somatosensory evoked potential (SEP). Sensitivity, specificity, PPV, and NPV were calculated for SEP.

Results

Thirty-one children (average age 8.3 ± 2.9 years) were included in the study. SEP was abnormal in 13 (41.9%), and MRI was abnormal in 8 (25.8%) patients. SEP was found to have a sensitivity of 87.5%, a specificity of 73.9%, positive predictive value of 53.85%, and negative predictive value (NPV) of 94.4%.

Conclusion

In patients with treatment refractory OAB, SEP is an important tool for the screening of tethered cord/spinal pathologies. Our results suggest that a child with a normal SEP study in this group of patients may not require further investigation with MRI.

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References

  1. Ayan S, Topsakal K, Gokce G, Gultekin EY (2007) Efficacy of combined anticholinergic treatment and behavioral modification as a first line treatment for nonneurogenic and nonanatomical voiding dysfunction in children: a randomized controlled trial. J Urol 177:2325–2328 discussion 2328–9

    Article  CAS  PubMed  Google Scholar 

  2. Chase J, Austin P, Hoebeke P, McKenna P (2010) The management of dysfunctional voiding in children: a report from the Standardisation Committee of the International Children’s Continence Society. J Urol 183:1296–1302

    Article  PubMed  Google Scholar 

  3. Hoebeke P, Renson C, Petillon L et al (2002) Percutaneous electrical nerve stimulation in children with therapy resistant nonneuropathic bladder sphincter dysfunction: a pilot study. J Urol 168:2605–2607 discussion 2607–8

    Article  CAS  PubMed  Google Scholar 

  4. Maternik M, Krzeminska K, Zurowska A (2014) The management of childhood urinary incontinence. Pediatr Nephrol. doi:10.1007/s00467-014-2791-x

    PubMed  PubMed Central  Google Scholar 

  5. Malm-Buatsi E, Nepple KG, Boyt MA et al (2007) Efficacy of transcutaneous electrical nerve stimulation in children with overactive bladder refractory to pharmacotherapy. Urology 70:980–983

    Article  PubMed  Google Scholar 

  6. Khen-Dunlop N, Van Egroo A, Bouteiller C et al (2006) Biofeedback therapy in the treatment of bladder overactivity, vesico-ureteral reflux and urinary tract infection. J Pediatr Urol 2:424–429

    Article  PubMed  Google Scholar 

  7. Lordêlo P, Benevides I, Kerner EG et al (2010) Treatment of non-monosymptomatic nocturnal enuresis by transcutaneous parasacral electrical nerve stimulation. J Pediatr Urol 6:486–489

    Article  PubMed  Google Scholar 

  8. Varlam DE, Dippell J (1995) Non-neurogenic bladder and chronic renal insufficiency in childhood. Pediatr Nephrol 9:1–5

    Article  CAS  PubMed  Google Scholar 

  9. Yamada S, Iacono RP, Andrade T et al (1995) Pathophysiology of tethered cord syndrome. Neurosurg Clin N Am 6:311–323

    CAS  PubMed  Google Scholar 

  10. Steinbok P, MacNeily AE (2007) Section of the terminal filum for occult tethered cord syndrome: toward a scientific answer. Neurosurg Focus 23:E5

    Article  PubMed  Google Scholar 

  11. Khoury AE, Hendrick EB, McLorie GA et al (1990) Occult spinal dysraphism: clinical and urodynamic outcome after division of the filum terminale. J Urol 144:426–428 discussion 428–9, 443–4

    Article  CAS  PubMed  Google Scholar 

  12. Nazar GB, Casale AJ, Roberts JG, Linden RD (1995) Occult filum terminale syndrome. Pediatr Neurosurg 23:228–235

    Article  CAS  PubMed  Google Scholar 

  13. Kraft GH, Aminoff MJ, Baran EM et al (1998) Somatosensory evoked potentials: clinical uses. Muscle Nerve 21:252–258

    Article  CAS  PubMed  Google Scholar 

  14. Kiliçkesmez O, Barut Y, Taşdemiroğlu E (2003) MRI features of adult tethered cord syndrome. Tani Girisim Radyol 9:295–301

    PubMed  Google Scholar 

  15. McLone DG, La Marca F (1997) The tethered spinal cord: diagnosis, significance, and management. Semin Pediatr Neurol 4:192–208

    Article  CAS  PubMed  Google Scholar 

  16. Kale SS, Mahapatra AK (1998) The role of somatosensory evoked potentials in spinal dysraphism—do they have a prognostic significance? Childs Nerv Syst 14:328–331

    Article  CAS  PubMed  Google Scholar 

  17. Li V, Albright AL, Sclabassi R, Pang D (1996) The role of somatosensory evoked potentials in the evaluation of spinal cord retethering. Pediatr Neurosurg 24:126–133

    Article  CAS  PubMed  Google Scholar 

  18. Ko KF (2010) The role of evoked potential and MR imaging in assessing multiple sclerosis: a comparative study. Singap Med J 51:716–720

    CAS  Google Scholar 

  19. Haghighi SS, Mundis G, Zhang R, Ramirez B (2011) Correlation between transcranial motor and somatosensory-evoked potential findings in cervical myelopathy or radiculopathy during cervical spine surgery. Neurol Res 33:893–898

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Surgery, Maltepe University Faculty of Medicine, Istanbul, Turkey

    David Terence Thomas

  2. Department of Pediatric Surgery, Marmara University School of Medicine, Istanbul, Turkey

    Sevim Yener & Aybegum Kalyoncu

  3. Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey

    Kayihan Uluc

  4. Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey

    Yasar Bayri & Adnan Dagcinar

  5. Division of Pediatric Urology, Department of Pediatric Surgery, Marmara University School of Medicine, Istanbul, Turkey

    Tolga Dagli & Halil Tugtepe

Authors
  1. David Terence Thomas
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  2. Sevim Yener
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  3. Aybegum Kalyoncu
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  4. Kayihan Uluc
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  5. Yasar Bayri
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  6. Adnan Dagcinar
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  7. Tolga Dagli
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  8. Halil Tugtepe
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Correspondence to Halil Tugtepe.

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Thomas, D.T., Yener, S., Kalyoncu, A. et al. Somatosensory evoked potentials as a screening tool for diagnosis of spinal pathologies in children with treatment refractory overactive bladder. Childs Nerv Syst 33, 1327–1333 (2017). https://doi.org/10.1007/s00381-017-3393-2

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  • DOI: https://doi.org/10.1007/s00381-017-3393-2

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