A 10 year review of the endoscopic treatment of 125 spinal cord injured patients with vesical outlet obstruction: does bladder neck dyssynergia exist?
The management of 125 patients with post-traumatic neuropathic bladder and vesical outlet obstruction is described and a policy of endoscopic treatment is suggested. A total of 1652 spinal cord injured patients were treated during the period of 1983-1992. About 8% had an outlet of obstruction which required endoscopic treatment. The outcome of transurethral resection of the external sphincter and/or bladder neck was retrospectively analyzed in 82 patients, and a prospective study was conducted on the other 43 patients. We have demonstrated that patients with a complete spinal cord lesion at any level, and those with a high incomplete lesion (above T-9) have benefited from external sphincterotomy combined with bladder neck resection. We emphasize that patients with a low incomplete lesion (T-9 and below) have benefited from bladder neck resection alone. Bladder neck (internal sphincter) obstruction or dyssynergia may require to be considered in the management of the neuropathic bladder.
Al-Ali
M
M
Department of Urology and Transplantation, Al-Rasheed Military Hospital, Baghdad, Iraq.
Haddad
L
L
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003558:Cystoscopy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000601:surgery*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control
D000900:Anti-Bacterial Agents