The silastic urethral ligature: an aid to catheter management

A technique is described for improving catheter control in patients with neuropathic bladder who have inadequate sphincter tone to retain an indwelling catheter without leaking or to remain dry with a regime of intermittent catheterisation. The urethra or bladder neck is narrowed by one or more ligatures of silastic tubing. 24 patients were operated upon. Results were excellent in 6, satisfactory in 5 and a failure in 13. Successful results are easier to achieve in males than females. In the latter, an alternative method of narrowing the bladder outlet would be preferable. The operation does not spoil the operative field for a possible future artificial sphincter insertion.