Pollakiuria: a rare and unique mode of revelation of silent dorsal syringomyelia in a young man—a case report

Introduction: Syringomyelia is a rare pathology which is rarely revealed by urinary urgency. We report the case of a 20-year-old man with persistent urinary urgency and pollakiuria for two years, with no identifiable organic cause despite a thorough urological work-up. A transient episode of lower limb atony prompted spinal MRI, which revealed an isolated syrinx at the T6–T7 level, without associated Chiari malformation or conus medullaris involvement. The final diagnosis was vesico-sphincter dyssynergia with overactive bladder syndrome secondary to idiopathic thoracic syringomyelia. Conservative management, including anticholinergic therapy and psychological support, led to significant clinical improvement. Conclusion: As illustrated by our case, syringomyelia may present exclusively with urinary symptoms. However, such presentation is uncommon. This case highlights the importance of considering spinal cord pathology in the differential diagnosis of unexplained urinary symptoms, even in the absence of overt neurological deficits.