Sexual impotence: a complication of external sphincterotomy

In paraplegic patients with upper motor neuron lesions, endoscopic sphincterotomy is a commonly used procedure to lower sphincter resistance and facilitate voiding. The technique yields 95% satisfactory clinical results. In the recent literature several authors report on temporary or permanent loss of erections after sphincterotomy. The 3 and 9 o'clock incision and resection appear to carry a higher risk (30-60%) than operations performed at the 1 and 11 o'clock or the 12 0'clock position (0-6%). Impairment of erectile reflex activity is more frequently observed in cases with severe intraoperative bleeding requiring deep coagulation and in the event of reoperation. We report on the clinical, radiological and urodynamic findings of a series of 47 cases (3 and 9o'clock resections). Partial and/or temporary inhibition of erection was observed in 5, total and permanent loss in 1 patients.=