PURPOSE: To evaluate middle term results of surgical sphincterotomy in neurogenic bladder dysfunction with detrusor-sphincter dyssynergia.
PATIENTS AND METHOD: Retrospective study about 44 patients whom underwent urinary sphincterotomy between January 2008 and September 2012. All patients had detrusor-sphincter dyssynergia. Mean age was 49.7years. Seventy percent (n=30) of patients had spinal cord injury, 80% (n=34) underwent urethral stent. Sphincterotomy was performed in 55% (n=24) with monopolar resection and in 43% (n=19) with Revolix® laser, after urethral stent withdrawal.
RESULTS: Mean follow-up was 30 months. Mean hospitalization stay was 5 days. Mean preoperative post-voiding residue (PVR) was 149mL and postoperative was 176mL. Twenty-nine percent (n=13) underwent new sphincterotomy with a final mean 116mL PVR, and a mean delay before new sphincterotomy of 9 months. Twenty percent (n=9) underwent other surgical procedure for sphincterotomy fail.
CONCLUSION: In this series, we observed that surgical sphincterotomy is a well tolerated procedure, but with moderate immediate efficiency about 57%. It requires sometimes second procedure and long term follow-up in order not to fail to recognize stenosis, with best surgical success (80%).
Written by:
Adam E, Palamara C, Briant PE, Coste AC, Ruffion A. Are you the author?
Service de chirurgie urologique, centre hospitalier Lyon Sud, 165, chemin du Grand Revoyet, 69310 Pierre Bénite, France; Université Claude-Bernard Lyon-1, 8, avenue Rockefeller, 69373 Lyon, France.
Reference: Prog Urol. 2013 Dec;23(17):1500-4.
doi: 10.1016/j.purol.2013.07.017
PubMed Abstract
PMID: 24286552
Article in French.
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