Pan David, Troy Andrew, Rogerson John, Bolton Damien, Brown Doug, Lawrentschuk Nathan
Department of Urology, Austin Health, Victoria, Australia.
J Urol. 2009 Feb;181(2):705-9. doi: 10.1016/j.juro.2008.10.004. Epub 2008 Dec 16.
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.
外括约肌切开术是治疗逼尿肌-括约肌协同失调患者的一种公认的选择。然而，长期结果数据有限。我们确定了该手术的治疗结果。
回顾了一家大型三级转诊脊髓损伤中心接受外括约肌切开术患者的数据库。
84例初次括约肌切开术的成功结果平均持续时间为81个月。30例患者需要进行第二次手术，此后成功的平均持续时间为80个月。84例患者中有57例（68%）最终出现复发性尿路感染症状、复发性逼尿肌-括约肌协同失调或上尿路扩张。所有患者均未发生肾衰竭。
外括约肌切开术可保护上尿路，并能在较长时间内实现满意的膀胱排空。然而，可能需要持续进行修正，并且应将其视为一种分阶段的干预措施。
