Selective sacral rootlet neurectomy in the treatment of detrusor hyperreflexia. Technique and long-term results.

Selective sacral neurectomy was performed in 12 patients with intractable urge incontinence of long duration (mean 12 years) caused by detrusor hyperreflexia. There was great variation in the innervation of the bladder, but resection of an S-3 root or rootlet was carried out in all patients. Six of the patients, who were followed for a mean period of 5.8 years, were cured, and symptoms recurred in two patients after 1 1/2 and 2 years. In patients whose detrusor hyperreflexia recurred, the amplitude of the bladder contractions was significantly lower. This treatment appears reasonable in patients with severe intractable voiding dysfunction caused by detrusor hyperreflexia.