Bladder outlet surgery in men with spinal cord injury.

The effect of bladder outlet surgery on voiding ability, changes in the upper urinary tract and urinary infections was studied in 51 men with spinal cord injury. In 24 patients reoperation was required after varying periods of time to achieve satisfactory bladder voiding. Eight of the 22 men who had undergone external sphincterotomy had constant dribbling of urine postoperatively. Dilation of the upper urinary tract was completely reversed or reduced in 13 of 18 patients following the primary operation on the bladder outlet. Vesico-ureteric reflux was found in 6 of the 8 men in whom deterioration of the upper urinary tract persisted after the initial operation or appeared during the follow-up years. Bacteriuria usually persisted, despite bladder outlet surgery, but febrile attacks of urinary tract infection ceased or became less frequent in 15 of the 22 patients who had experienced such episodes preoperatively.