Stories about: Stuart Bauer

Tethered cord syndrome: Improving early detection

Tethered Cord TitleA significant number of children with a tethered spinal cord have a cutaneous manifestation overlying the lower spine, yet the ability to diagnose it often depends on the knowledge and familiarity of this condition by the primary care provider. Since early identification and treatment may prevent further neurologic deterioration and improve outcome if neuro-urologic injury has already occurred, it is imperative to expedite the timing of diagnosis.

The aims of this study were two-fold: (1) to determine the frequency and (2) to increase awareness of spinal cord abnormalities in a cohort of patients with a variety of subtle cutaneous lower spinal lesions.

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Clinical Consult: Weighing the risks and benefits of Deflux for reflux

vesicoureteral reflux VUR deflux Dx/HA

It’s estimated that one in three children with recurrent urinary tract infections have vesicoureteral reflux (VUR), a urological condition where urine flows backwards from the bladder to the kidney.

Though the condition’s management has evolved, the question of which treatment is the preferred one — and specifically, whether urologists should continue to turn to endoscopic injections of dextranomer/hyaluronic acid copolymer (Dx/HA, aka Deflux) — remains a source of debate.

Boston Children’s Urologist-in-Chief, David Diamond, MD and colleagues Alan B. Retik, MD and Stuart B. Bauer, MD, researched Dx/HA use, and determined that due to its:

  1. high failure rate
  2. long-term complication rate
  3. high re-treatment rate
  4. high (and rising) cost

the risks of Dx/HA far outweigh its limited benefits in a majority of patients.

Read Boston Children’s “Caution in Employing Deflux for Reflux – The Thinking Behind Our Approach” white paper and find out why our urology experts say Dx/HA should not be considered as a preferred treatment option for children with VUR.

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