Division of the external urethral sphincter in the treatment of the paraplegic bladder: a preliminary report on a new procedure

Abstract

Division or resection of the external sphincter is a new operation designed to relieve retention of urine (or a high residue) in patients with an open bladder-neck and a narrow, rigid external sphincter area and in whom subarachnoid alcohol block, pudendal neurectomy or a bladder-neck resection have failed to help. The operation converts a chronic retention to an easily expressible bladder. Ten patients are reported. The operation technique is described. During the post-operative period care is necessary in preventing or dealing with clot-retention and with severe infection due to absorption of organisms in the urethra. The operation should not be attempted in patients with grossly dilated upper urinary tracts and in those with uncontrollable infection. The eight surviving patients have been spared the catheter life and, possibly, subsequent damage to the upper urinary tract.