THE ROLE OF EXTERNAL SPHINCTEROTOMY FOR PATIENTS WITH A SPINAL-CORD LESION

For the last three decades external sphincterotomy has been well accep ted as a treatment for bladder outlet obstruction in patients with a s pinal cord lesions. Recently, however, its value has been brought into question. To assess the current place of this procedure in the treatm ent of the neuropathic bladder of spinal origin, we studied the outcom es of sphincterotomy in 32 patients. Post-voiding residual urine volum e decreased after surgery in 27 patients (84%), considerably in 22 (69 %) of them. Clinical infection resolved in 14 out of 19 patients (74%) , hydronephrosis disappeared in two out of three (66%), and vesicouret hral reflux improved in three but of five (60%) and was cured in two ( 40%). Six of the patients (19%) were freed from catheterization, but t wo patients (6%) lost partial continence. Sphincterotomy is an importa nt tool in the treatment of spinal patients with bladder outlet obstru ction and should be considered when the proper indications exist.