Transurethral balloon dilation of the external urinary sphincter: effectiveness in spinal cord-injured men with detrusor-external urethral sphincter dyssynergia.
The authors investigated balloon dilation as a minimally invasive alternative to transurethral external sphincterotomy for the treatment of detrusor-external urethral sphincter dyssynergia (DESD). Seventeen spinal cord-injured men with voiding pressures greater than 60 cm H2O underwent balloon dilation of the external sphincter to 90 F at 4 atm of pressure for 10 minutes. The mean voiding pressures before and 12 months after dilation were 83 cm H2O +/- 35 and 37 cm H2O +/- 15, respectively (P = .008). There was a significant decrease in residual urine volume, from 163 mL +/- 162 to 68 mL +/- 59 (P = .05), whereas bladder capacity remained relatively unchanged at 253 mL +/- 181 and 230 mL +/- 97 (P = .30). Complications included one case of postoperative bleeding necessitating transfusion, two treatment failures, and one bulbous urethral stricture. Fourteen of the 17 patients (82%) now void without the aid of an indwelling catheter or alternative therapy. Balloon dilation has no detrimental effect on erectile function and may improve fertility.
Chancellor
M B
MB
Department of Urology, Jefferson Medical College, Philadelphia, PA 19107.
Karasick
S
S
Strup
S
S
Abdill
C K
CK
Hirsch
I H
IH
Staas
W E
WE
D000328:Adult; D002404:Catheterization / Q000009:adverse effects; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D013119:Spinal Cord Injuries / Q000150:complications*; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D016055:Urinary Retention / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics