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


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.
Pan
David
D
Department of Urology, Austin Health, Victoria, Australia. dpan1111@yahoo.com.au
Troy
Andrew
A
Rogerson
John
J
Bolton
Damien
D
Brown
Doug
D
Lawrentschuk
Nathan
N
D000328:Adult; D015331:Cohort Studies; D003558:Cystoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D017060:Patient Satisfaction; D011788:Quality of Life; D012042:Registries; D018570:Risk Assessment; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis; D013997:Time Factors; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014552:Urinary Tract Infections / Q000517:prevention & control*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods*; D014739:Victoria; D055815:Young Adult