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External sphincterotomy in functional urinary bladder outlet obstruction

E Koskela

    Annales Chirurgiae Et Gynaecologiae
    |January 1, 1982
    PubMed
    Summary
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    Transurethral external sphincterotomy effectively treated urinary obstruction in most male patients. This procedure improved voiding for 91% of men, offering a solution for functional urinary disorders without organic causes.

    Area of Science:

    • Urology
    • Surgical Procedures
    • Lower Urinary Tract Symptoms

    Background:

    • Functional urinary disorders without organic obstruction can cause significant voiding difficulties.
    • Transurethral external sphincterotomy is a potential treatment for such conditions.

    Purpose of the Study:

    • To evaluate the efficacy of transurethral external sphincterotomy in patients with obstructive symptoms and hypoactive bladders.
    • To assess outcomes in both male and female patients undergoing the procedure.

    Main Methods:

    • Synchronous pressure-flow-electromyography investigations were performed on 38 patients (36 male, 2 female).
    • Patients were diagnosed with hypoactive bladders without organic obstruction via urethroscopy, micturition urethrocystography, urethral pressure profile, and sphincterometry.

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  • Sphincterotomy was performed at the 12 o'clock position.

    • Main Results:

    • Voiding improved in 33 (91%) of 36 male patients.
    • 11 patients presented with urinary retention prior to the procedure.
    • Reoperations (15 sphincterotomies in 7 patients) were most common within 3 months; transurethral resection of the prostate was performed in 4 patients, causing incontinence in one.

    Conclusions:

    • External sphincterotomy is a suitable and effective treatment for male patients experiencing functional urinary disorders without organic obstruction.
    • Outcomes in female patients were less favorable, with one requiring self-catheterization despite multiple procedures.