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

Abstract

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. A database was reviewed for patients undergoing external sphincterotomy at a large tertiary referral spinal injuries center. 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. 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.