Long-term outcomes of external sphincterotomy in a spinal injured population

J Urol. 2009 Feb;181(2):705-9. doi: 10.1016/j.juro.2008.10.004. Epub 2008 Dec 16.

Abstract

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.

MeSH terms

  • Adult
  • Cohort Studies
  • Cystoscopy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Patient Satisfaction
  • Quality of Life
  • Registries
  • Risk Assessment
  • Spinal Cord Injuries / complications*
  • Spinal Cord Injuries / diagnosis
  • Time Factors
  • Treatment Outcome
  • Urinary Bladder, Neurogenic / etiology
  • Urinary Bladder, Neurogenic / physiopathology
  • Urinary Bladder, Neurogenic / surgery*
  • Urinary Tract Infections / prevention & control*
  • Urodynamics
  • Urologic Surgical Procedures / methods*
  • Victoria
  • Young Adult