[Endoscopic sphincterotomy in paraplegic patients: retrospective cases in Geneva]

We present a review of 59 spinal cord injury patients with spastic sphincter, treated by external sphincterotomy. Bladder voiding is substantially improved with either twelve o'clock or lateral sphincterotomy. Immediate complications are infrequent. 19% of patients need a second intervention. 78% of patients obtain satisfactory long-term results. Conversely, 12% of patients fail to respond and need an indwelling bladder catheter. Those failures are most likely to be found in patients presenting an impaired detrusor function (40%). 72% of patients have erections before treatment. Among them, 10% report erection loss after sphincterotomy. Fibrosis is present in 71% of sphincter resection piece histologies and appears early in the evolution of the affection. This condition is thought to contribute notably to the formation of a fixed sphincteric obstacle.