Perkash I
Paraplegia. 1976 Feb;13(4):247-60. doi: 10.1038/sc.1976.39.
Indications, technique and results of a modified approach to an extended sphincterotomy in spinal cord injury patients with voiding dysfunctions is presented. There were 32 patients who underwent surgery and were subjected to analysis for their dysfunctional bladder and bladder-neck problems. Overall satisfactory results were obtained in about 90 per cent patients following sphincterotomy. Early recognition of patients where intermittent catheterisation may not succeed is presented to intervene and establish an early catheter-free status in such patients. Foley indwelling catheter in ten patients, being worn from seven months to four years, where intermittent catheterisation had not succeeded elsewhere, were decatheterised following surgery. Excellent results were obtained in ten patients with vesico-urethral reflux; external sphincterotomy, therefore, seems to be the treatment of choice for complete spinal cord transection with vesico-ureteral reflux. An attempt has also been made to present physiology of micturition reflex in spinal cord injury patients.
本文介绍了一种改良的扩大括约肌切开术在脊髓损伤伴排尿功能障碍患者中的适应症、技术及结果。共有32例患者接受了手术，并对其功能失调的膀胱和膀胱颈问题进行了分析。括约肌切开术后，约90%的患者取得了总体满意的结果。本文还介绍了如何早期识别间歇性导尿可能不成功的患者，以便进行干预并使这类患者尽早实现无导尿管状态。10例患者留置Foley导尿管7个月至4年，此前在其他地方间歇性导尿均未成功，术后拔除了导尿管。10例膀胱输尿管反流患者取得了极佳的效果；因此，对于完全性脊髓横断合并膀胱输尿管反流的患者，外括约肌切开术似乎是首选的治疗方法。本文还尝试阐述了脊髓损伤患者排尿反射的生理学。
