{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:07:05Z","timestamp":1789992425871,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare unsafe storage\u2010pressure urodynamic findings in children with radiological suspicion or confirmation of tethered spinal cord and in clinically referred children without radiological tethering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This single\u2010center retrospective comparative study included children aged 2\u201318 years who underwent urodynamic testing between October 2024 and December 2025 and had available spinal magnetic resonance imaging. Of 172 children assessed, 52 were excluded because spinal MRI was unavailable. The final cohort included 120 children: 60 with radiological tethering and 60 without tethering. The primary outcome was an unsafe storage\u2010pressure urodynamic pattern. Post\u2010void residual urine was excluded from the primary composite outcome and analyzed separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Age and sex were comparable between groups. Unsafe storage\u2010pressure urodynamics were more frequent in the radiological tethered cord group than in the non\u2010tethered comparison group (48.3% vs. 21.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Low compliance, elevated end\u2010filling pressure, high\u2010pressure detrusor overactivity, detrusor\u2010sphincter dyssynergia, and increased post\u2010void residual urine were also more common. MRI and urodynamic risk were not fully concordant: 51.7% of children with radiological tethering had safe storage\u2010pressure urodynamics, whereas 21.7% without tethering had unsafe findings. Radiological tethering alone demonstrated a sensitivity of 69.0%, specificity of 60.3%, positive predictive value of 48.3%, and negative predictive value of 78.3% for unsafe storage\u2010pressure urodynamics. In multivariable analysis, radiological tethering, increased post\u2010void residual urine, and hydronephrosis were independently associated with unsafe storage\u2010pressure urodynamics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Radiological tethering was associated with unsafe storage\u2010pressure urodynamic findings, but MRI alone did not define functional bladder safety. Increased post\u2010void residual urine and hydronephrosis may identify children at higher risk; however, these findings are hypothesis\u2010generating and do not establish a validated pathway for safely withholding urodynamic testing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70453","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:16:14Z","timestamp":1789989374000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Storage\u2010Pressure Urodynamic Risk in Children With Radiological Suspicion of Tethered Spinal Cord: A Single\u2010Center Retrospective Comparative Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8457-5108","authenticated-orcid":false,"given":"Yusuf Atakan","family":"Baltrak","sequence":"first","affiliation":[{"name":"Department of Pediatric Urology Adana City Training and Research Hospital Adana T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0567-3581","authenticated-orcid":false,"given":"Hasan","family":"Delia\u011fa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology Bursa Y\u00fcksek \u0130htisas Training and Research Hospital Bursa T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-003-0829-7"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JU.0000140140.75441.F0"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-014-1414-2"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23382"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.01.110"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.5213\/inj.2142246.123"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3171\/2017.5.PEDS16719"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.22783"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-008-0764-7"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1984.03350050038023"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/JNS.1996.85.4.0555"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2016.02.012"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2015.08.011"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)65216-9"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3171\/PED.2006.105.5.391"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2006.03.116"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2001-14899"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2014.06.008"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.03.193"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-015-0550-6"},{"key":"e_1_2_12_22_1","first-page":"20","article-title":"Urodynamics in Normal Infants and Children","volume":"114","author":"Hj\u00e4lm\u00e5s K.","year":"1988","journal-title":"Scandinavian Journal of Urology and Nephrology"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)65594-2"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.22342"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7992"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280218784726"},{"key":"e_1_2_12_27_1","volume-title":"EAU\u2010ESPU\u2010ERN eUROGEN\u2010ERN ITHACA\u2010ERN ERKNet\u2010IFSBH Guidelines on Spinal Dysraphism in Children and Adolescents: Clinical Guideline","author":"Abrahamson K.","year":"2024"},{"key":"e_1_2_12_28_1","volume-title":"EAU Guidelines. 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