Urinary Manometry in Spinal Cord Injury: a Follow‐up Study. Value of Cysto‐Sphincterometrography as an Indication for Sphincterotomy

Summary Results are reported of transurethral sphincterotomy performed in para‐ and tetra‐plegic patients. Indications and complications of the procedure are discussed. Six patients required multiple sphincterotomies before obtaining satisfactory bladder function. After failure of the initial sphincterotomy 11 patients required additional bladder neck resection. After sphincterotomy, with or without supplementary bladder neck resection, the volume of residual urine remained between 50 and 100 ml in 2 patients, and fell below 50 ml in 24. A technique for recording pressure within the membranous urethra via a special balloon catheter allowed objective measurement of the results of the procedure. At the level of the distal part of the external urethral sphincter, just at the beginning of the bulbous urethra, an average reduction in pressure of the order of 67 % was found postoperatively. It has been found that the power of the bladder contraction determines which patients benefit from sphincterotomy alone and those who require concomitant bladder neck resection.