Anteromedian external urethral sphincterotomy: technique, rationale and complications

Experiences are presented with bilateral (3 and 9 o'clock incisions) and anteromedian (12 o'clock incision) external urethral sphincterotomy in 84 patients with neuropathic vesicourethral dysfunctions. Hemorrhage and loss of reflexogenic erections have been notably absent in 31 patients who underwent anteromedian sphincterotomy. The rationale is discussed for the preference of anteromedian over bilateral sphincterotomy based on postoperative complications. The postoperative, radiologically aided cystosphincterometric and electromyographic studies during micturition indicated the adequacy of the surgical procedures, satisfying the urodynamic criteria, although dyssynergic myolectric activity of the periurethral striated muscle continued to exist.