Radical transurethral resection of the prostate in male paraplegics revisited: further clinical experience and urodynamic considerations for its effectiveness.
We report our experience with radical transurethral resection of the prostate performed on 89 male spinal cord injury subjects. The over-all success rate of modified sphincterotomy was 90 per cent, although there was a 14 per cent recurrence rate with time. Urodynamically, success was characterized by a statistically significant reduction in the degree of detrusor-sphincter dyssynergia, an increase in vesical compliance and a reduction in detrusor hyperreflexia. These results suggest an effect on the distal sphincteric area by the adrenergic system in the genesis of detrusor-sphincter dyssynergia. It is suggested that radical transurethral resection of the prostate exerts this effect via a surgical sympathectomy, while continence is preserved by the activity of the untouched external urethral sphincter.
D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000503:physiopathology*; D011468:Prostatectomy; D014521:Urethra / Q000503:physiopathology; D001743:Urinary Bladder / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology / Q000628:therapy*; D014554:Urination; D014563:Urodynamics