Postoperative Bowel and Urinary Dysfunction of Sacrococcygeal Teratoma

Abstract

Background: Teratomas are composed of multiple tissues foreign to the organ or site from which they arise. Although teratomas are sometimes defined as having three embryonic layers (endoderm, mesoderm, and ectoderm), and are generally divided into gonadal and extragonadal types. The most common extragonadal type being sacrococcygeal teratomas which constitute the most prevalent childhood germ-cell cancers.

Objective: To assess   postoperative bowel and urinary dysfunction in babies with sacrococcygeal teratomas

Patients and Methods: 23 patients having sacrococcygeal teratomas were received at the time between May  2014 to September 2022 at the department of pediatric surgery in Raparen Teaching Hospital in Erbil city.All recorded data from case note, operation notes together with demographic data and operative details obtained and recorded . The follow-up time span was between  three months to seven years.

Results: The age range was from 1 day to 4year, (median 3 days) , Presenting features include posterior sacral mass in 17 cases (73.9%), pelviabdominal mass in 5 cases (21.7%), urinary retention in 4 cases (17.4%), palpable rectal mass in 2 cases 98.7%), intestinal obstruction in 1 case (4.3%), and constipation in 4 cases (17.4%). Eight cases (34.8%) were type I, 6 cases (26.1%) type II and III, and 3 cases (13%) were type IV. postoperative complications were wound infection in 4 patients (17.4%), constipation in 5 cases (21.7%), 1 (4.3%) ugly scar arranged for aesthetic operation, fistula 1(4.3%) case, recurrence in 1(4.3%).

Conclusion: Patients with sacrococcygeal teratoma were more likely to experience uncontrolled urination, difficulties emptying the bladder, pyelonephritis, and constipation than healthy children. Children with big and immature teratomas had a higher prevalence of dysfunctional outcomes.