Long-Term Outcomes of External Sphincterotomy in a Spinal Injured Population
Purpose
External sphincterotomy is an accepted option for treating patients with detrusor-sphincter dyssynergia. However, long-term outcome data are limited. We ascertained the outcome of treatment results for this procedure.
Materials and Methods
A database was reviewed for patients undergoing external sphincterotomy at a large tertiary referral spinal injuries center.
Results
For 84 primary sphincterotomies the mean duration of successful outcome was 81 months. A second procedure was required in 30 patients and mean duration of success thereafter was 80 months. Recurrent symptomatic episodes of urinary tract infection, recurrent detrusor-sphincter dyssynergia or upper tract dilatation eventually ensued in 57 of 84 patients (68%). Renal failure did not develop in any patients.
Conclusions
External sphincterotomy protects the upper renal tracts and provides extended periods of satisfactory bladder emptying. However, it may require ongoing revision and should potentially be regarded as a staged intervention.
Key Words: spinal cord injuries, sphincterotomy, endoscopic
Abbreviations and Acronyms: DSD, detrusor-sphincter dyssynergia, SCI, spinal cord injured, UTI, urinary tract infection
Nothing to disclose.
Editor's Note: This article is the fifth of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 928 and 929.
PII: S0022-5347(08)02690-6
doi:10.1016/j.juro.2008.10.004
© 2009 American Urological Association. Published by Elsevier Inc. All rights reserved.
Refers to erratum:
- Erratum , 26 February 2009