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[External sphincterotomy using bipolar vaporisation in saline. First results].
L Even1, J Guillotreau, N Mingat
1Service d'urologie, transplantation rénale et andrologie, CHU de Rangueil, TSA 50032, 31059 Toulouse, France.
Summary
External urethral sphincter vaporization in saline is a feasible and effective treatment for detrusor-sphincter dyssynergia. However, this procedure carries a significant risk of developing urethral strictures.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Nephrology
Context:
- Neurogenic detrusor-sphincter dyssynergia (DSD) significantly impacts bladder emptying.
- Current treatments for DSD have limitations.
- External urethral sphincter (EUS) dysfunction is a key component of DSD.
Purpose:
- To evaluate the feasibility, efficacy, and safety of EUS vaporization in saline for DSD.
- To assess the long-term outcomes of this novel surgical approach.
- To compare the results with existing DSD treatment modalities.
Summary:
- A prospective study of ten men with neurogenic DSD assessed EUS vaporization in saline.
- Post-procedure, 80% of patients achieved successful bladder emptying, while 20% experienced persistent urinary retention.
- Complications included one case of orchitis and four cases of urethral stricture.
Impact:
- External urethral sphincter vaporization in saline demonstrates potential as an effective treatment for DSD.
- The procedure's feasibility is confirmed, offering a new therapeutic option.
- High incidence of urethral stricture necessitates further investigation and risk mitigation strategies.
