Indian Journal of Urology Users online:373  
Home Current Issue Ahead of print Editorial Board Archives Symposia Guidelines Subscriptions Login 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size
Year : 2018  |  Volume : 34  |  Issue : 1  |  Page : 56-61

Symptomatic lower urinary tract dysfunction in sacral agenesis: Potentially high risk?

1 Department of Urology, Apollo Hospitals, Hyderabad, Telangana, India
2 Department of Nephrology, Apollo Hospitals, Hyderabad, Telangana, India

Correspondence Address:
Sanjay Sinha
Department of Urology, Apollo Hospitals, Hyderabad, Telangana
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/iju.IJU_184_17

Rights and Permissions

Introduction: Sacral agenesis (SA) is a caudal regression anomaly that can cause neurogenic bladder but is not generally recognized as high risk. We studied the clinical presentation, upper urinary tract, bone and spine abnormalities, and urodynamic findings in patients with SA and compared them with related high-risk conditions, anorectal malformation (ARM), and cloacal malformation. Materials and Methods: Patient records between May 2011 and December 2015 were identified and grouped into isolated SA without an overt anomaly (Group I), SA with overt caudal regression anomalies (Group II), and ARM or cloacal malformation without the SA (Group III). Distribution of clinical and urodynamic findings and factors associated with reduced eGFR were tested with rank sum test, t-test, and unadjusted odds (P < 0.05 significant) using R statistical program (version 3.1.3). Results: Of 605 neurogenic bladder patients treated in the study period, 39 fulfilled the inclusion criteria. 12 were Group I, 5 Group II, and 22 Group III. Long-standing lower urinary symptoms were noted in all SA patients. Group I patients were older (14.5 years vs. 6 years and 5 years for II and III). Patients with SA (Group I and II) had poor compliance (6.7 ml/cmH2O, interquartile range [IQR] 4–13.6 ml/cmH2O), reduced age-adjusted bladder capacity (59%, IQR 22–85%), elevated end-fill pressure (22 cmH2O, IQR 11–28 cmH2O), hydronephrosis (88%), and reduction in eGFR (29%), all comparable to Group III. Most had Renshaw type II SA and tethered spinal cord rather than wedge-shaped termination. Limitations include small numbers and significant selection bias. Conclusions: Symptomatic neurogenic bladder due to SA may cause renal damage similar to ARM but often eludes diagnosis.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded158    
    Comments [Add]    
    Cited by others 2    

Recommend this journal