Urological comorbidities in sacrococcygeal teratoma: Prenatal diagnosis, perioperative management, and clinical outcomes within a centralized care model

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Background: Sacrococcygeal teratoma (SCT) is a rare neonatal tumor that typically requires early surgical intervention. Advances in prenatal imaging have improved early detection, yet data on long-term urinary outcomes remain scarce. Objective: This study aimed to evaluate functional outcomes in patients with prenatally diagnosed SCT and to explore whether early diagnosis combined with multidisciplinary care at a tertiary referral center influences urinary comorbidities or other sequelae. Methods: We retrospectively reviewed prenatally diagnosed SCT patients who underwent surgery between 2010 and 2021. A minimum follow-up of three years was required. Clinical, surgical, histological, and functional outcomes were analyzed. Correlations between urinary comorbidities and prenatal findings, tumor histology, size, Altman type, and surgical approach were explored. Results: Twenty-four patients were included. Most tumors were classified as Altman type I (66.7%), and half of the cases showed immature histology. Urinary comorbidities were identified in 3/24 (12.5%) patients, primarily in those with immature tumors and larger lesions, although they did not emerge as statistically significant predictors (rs = −0.37, p = 0.08; rs = 0.33, p = 0.17, respectively). No consistent association emerged between prenatal imaging findings, tumor stage, or surgical approach and urinary outcomes. Conclusion: Timely prenatal diagnosis and centralized multidisciplinary management may contribute to favorable long-term functional outcomes in SCT patients. Despite the lack of predictive value of prenatal imaging for urinary morbidity in this cohort, its role remains vital for early detection, surgical planning, and comprehensive patient care. Further prospective studies with larger cohorts are needed to clarify risk factors for functional impairment and improve prognostication in this population.

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