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The twelve o'clock sphincterotomy: technique, indications, results.
Paraplegia
|February 1, 1976
Summary
Transurethral sphincterotomy at the 12 o'clock position effectively treats neurogenic bladder outflow obstruction. This simple technique reduces urethral resistance, offering a preferable solution for patients with neurogenic bladder dysfunction.
Area of Science:
- Urology
- Neurosurgery
- Rehabilitation Medicine
Background:
- Neurogenic bladder dysfunction frequently causes external sphincter outflow obstruction.
- Transurethral sphincterotomy is the standard treatment for this condition.
Purpose of the Study:
- To evaluate the efficacy of a specific transurethral sphincterotomy technique.
- To determine the optimal approach for relieving external sphincter obstruction in neurogenic bladder.
Main Methods:
- Retrospective analysis of 35 patients with neurogenic bladder dysfunction.
- Focus on transurethral sphincterotomy performed at the 12 o'clock position.
- Follow-up data available for 17 patients, with 10+ years of observation.
Main Results:
- Transurethral sphincterotomy at the 12 o'clock position proved sufficient and preferable.
- This technique effectively diminished outflow resistance at the membranous urethra.
- Sphincterotomy is typically delayed for one year in acute paraplegics with reflex bladders.
Conclusions:
- A unilateral 12 o'clock transurethral sphincterotomy is an effective and preferred method.
- This approach successfully alleviates outflow obstruction in neurogenic bladder.
- Consideration for timing in acute paraplegia is crucial.