脊髓壓迫症候群很少以泌尿症狀做為病患第一個求診的症狀，因為排便異常有時並不顯著，常與其他尿失禁的疾病混淆，由於泌尿道併發症可能導致永久血液透析，早期診斷及治療是很重要的，本文將探討其臨床表現及嚴重性。從1995年至1999年共回溯收集五位脊髓壓迫症候群的病人，其平均年齡為30歲，他們都是以泌尿症狀來求醫的，其中四位是以下腹痛及腹脹為主要的症狀，尿動力學檢查顯示逼尿肌過度反射伴隨膀胱尿道括約肌不協調有四例，一例顯示逼尿肌低度反射及膀胱調適性不佳，所有病人均可以核磁共振掃描來診斷，四例行手術減壓迫治療，伴隨脂肪瘤切除，追縱結果發現有一例血液透析、二例慢性腎衰竭，僅有一例因早期發現早期治療維持腎功能正常；此外未手術之病人則維持間歇性自我導尿治療，但呈現慢性腎衰竭現象。由追蹤結果發現，本病若不早期診斷或延遲治療其預後不佳；建議在尿失禁或尿瀦留的病人要儘早診斷出本病，以挽救其腎功能，由於病例較少，更進一步的病例研究將有助於了解本病在泌尿系統的臨床表現。

Tethered cord syndrome is infrequently seen in out-patient urological department as urological problems do not present as the initial signs or symptoms for this syndrome. The symptom of voiding dysfunction is frequently confused with other causes of urinary incontinence. Due to long-term complications which can result in hemodialysis, early diagnosis of tethered cord syndrome is important. The aim of this study was to investigate the clinical manifestation and severity of tethered cord syndrome. From January 1995 through April 1999, we retrospectively collected the medical records of 5 patients with tethered cord syndrome who had an aver-age age of 30 yrs. They all presented with urological symptoms as the initial call for help. Four patients had predominant symptoms of lower abdominal fullness and pain. Detrusor hyperre-flexia with detrusor-sphincteric dyssynergia were seen in 4 patients. One patient presented with detrusor hyporeflexia and poor compliance as seen on the cystometrogram. Untethering surgeries with removal of lipoma were performed in 4 patients. One patient developed hemodi-alysis during the 1-yr follow-up period. Two patients showed persistent chronic renal insufficiency. Only l patient maintains normal renal function because of early diagnosis and early treatment. This result indicates that prognosis is poor when the diagnosis is delayed. We suggest early diagnosis and early treatment as the preferred way to resolve the problem of progressively worsening renal function. Because only a small number of patients were available, more studies of tethered cord syndrome would be helpful to clarify the clinical presentations of urological problems.