Tethered cord, diagnostic difficulty in adult. Report of a case.

INTRODUCTION: The tethered spinal cord syndrome is a malformation of the caudal region of the spine. Is a rare disease that occurs in 5% of the population, with an unusual start, and late diagnosis in adult. It can lead to neurological, musculoskeletal, urologic or gastrointestinal disorders. CASE REPORT: Fifty-yearold male patient with clinical and imaging evidence of tethered cord syndrome of symptomatic onset in adulthood, with urinary incontinence since 10 years ago. After study by urologist, benign prostatic hyperplasia is diagnosed and transurethral resection of the prostate is done, but urinary incontinence symptoms persist, requesting consultation with a neurologist who diagnosed tethered cord associated with a lumbosacral lipoma. DISCUSSION: The imaging examinations and the led physical examination, directed at a broader syndrome as tethered cord syndrome, in which patient’s initial clinical urological presented is one of the many possible manifestations of a syndrome throughout life go unnoticed. The absence of prior history of spinal cord dysfunction in childhood is responsible for the complexity to make the diagnosis more accurately. In adults, the time of surgery is controversial and no neurosurgical consensus exists.