Tethered cord syndrome in adult. A rare presentation

A 21 year-old female presented with acute renal failure and bilateral uretero-vesical junction obstruction. After percutaneous drainage of the upper tracts, the renal function returned to a baseline serum creatinine of 2,6 mg/dl. The initial evaluation supported a diagnosis of urinary tuberculosis and a triple drug therapy was instituted. Further reevaluation revealed the presence of a neurogenic bladder secondary to a lumbar intradural liposma associated with a thick filum terminale and a myelomeningocele. Tethered cord syndrome in adult is extremely rare and is classically responsible for urological, orthopedic and neurological dysfunctions. This isolated urological presentation with no significant associated neurologic deficits is unique and prompted this report, with a review of the current understanding and management of adult tethered cord syndrome.