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Related Experiment Videos

External urethral sphincterotomy: long-term follow-up

C C Yang1, M E Mayo

  • 1Department of Urology, University of Washington, Seattle 98159, USA.

Neurourology and Urodynamics
|January 1, 1995
PubMed
Summary

External sphincterotomy for spinal cord injury patients can have a high long-term failure rate, even with careful patient selection. No specific factors predicted unsuccessful outcomes in this study.

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Area of Science:

  • Urology
  • Neurosurgery
  • Rehabilitation Medicine

Background:

  • Spinal cord injury (SCI) often leads to lower urinary tract dysfunction.
  • Sphincterotomy is a surgical option to improve bladder emptying in select SCI patients.
  • Long-term outcomes of external sphincterotomy in SCI require further evaluation.

Purpose of the Study:

  • To assess the long-term efficacy and failure rates of external urethral sphincterotomy in male SCI patients.
  • To identify potential predictors of sphincterotomy failure in this population.

Main Methods:

  • Retrospective chart review of 37 male SCI patients who underwent sphincterotomy (1986-1993).
  • Patients selected based on urodynamic criteria with some detrusor activity or ability to void via Valsalva's maneuver.
  • Failure defined by postoperative large residual volumes, recurrent UTIs, autonomic dysreflexia, or upper tract deterioration.

Main Results:

  • Sphincterotomy was successful in 19 patients and failed in 18.
  • Common causes of failure included detrusor sphincter dyssynergy, detrusor hypocontractility, and bladder neck contracture.
  • The reoperation rate was 32%, with failures increasing over longer follow-up periods (mean 49 months vs. 26 months).

Conclusions:

  • External urethral sphincterotomy has a high potential for long-term failure in SCI patients, even when appropriately selected.
  • No specific patient parameters (age, injury level, prior surgeries, urodynamic measures) predicted operative success or failure.

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