title: [Surgical sphincterotomy in neurogenic bladder dysfunction with detrusor-sphincter dyssynergia].
abstract: OBJECTIVE
  To evaluate middle term results of surgical sphincterotomy in neurogenic bladder dysfunction with detrusor-sphincter dyssynergia.
  
  
  METHODS
  Retrospective study about 44 patients whom underwent urinary sphincterotomy between January 2008 and September 2012. All patients had detrusor-sphincter dyssynergia. Mean age was 49.7 years. 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.
  
  
  CONCLUSIONS
  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%).
authors.affiliation: 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. Electronic address: emilie.adam@chu-lyon.fr.
authors.forename: E
authors.initials: E
authors.lastname: Adam
authors.forename: C
authors.initials: C
authors.lastname: Palamara
authors.forename: P E
authors.initials: PE
authors.lastname: Briant
authors.forename: A C
authors.initials: AC
authors.lastname: Coste
authors.forename: A
authors.initials: A
authors.lastname: Ruffion
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009130:Muscle, Smooth / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000503:physiopathology; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
keywords: Detrusor-sphincter dyssynergia; Dyssynergie vésico-sphinctérienne; Neurogenic bladder; Sphinctérotomie chirurgicale; Surgical sphincterotomy; Vessie neurologique