The target population of this study is children with primary or secondary daytime urinary
incontinence, who have failed to improve adequately despite compliance with at least 6
months of standard medical therapy.
The study hypothesis is that patients who under go cutting the filum terminale - the
string-like lower end of the spinal cord - will have improved bladder function at 6-month
Bladder function and its effects on quality of life will be measured before surgery and at
6-month follow up.
- Primary or secondary daytime urinary incontinence, persistent over at least 6 months
of medical treatment.
- Abnormal urodynamic testing
- Normal conus on magnetic resonance imaging of the spine
- Dysfunctional Voiding Symptom Scale score greater than 6 for girls or greater than 9
- Bladder outlet obstruction
- Bladder atony
- Congenital anorectal malformation
- Additional diagnoses independently associated with neurogenic bladder dysfunction
- Encephalopathy precluding reasonable expectation of attainment of continence
- Inability to comply with medical management
- Unwillingness to comply with initial or follow up urodynamic testing