A further look at the rationale of 'external sphincterotomy'

A sound anatomical and physiological basis has now been provided for the endoscopic operations which are carried out for the relief of urethral obstruction due to spasticity of the external sphincter. However, the operation 'external sphincterotomy' was originally applied empirically to cases with sacral areflexia in which the mechanism of the obstruction was obscure. It now seems that plain muscle contraction under sympathetic control and influenced by posture is probably responsible and there are prospects of relief from the use of alpha-adrenergic blocking agents. When endoscopic incision is required, the operation might be better designated 'internal membranous urethrotomy'.