Koyanagi T, Arikado K, Tsuji I
J Urol. 1981 Apr;125(4):521-7. doi: 10.1016/s0022-5347(17)55093-4.
We herein report our experience with radical transurethral resection of the prostate in 50 paraplegics refractory to conventional conservative therapy, including the use of alpha-adrenolytic drugs and clean intermittent self-catheterization. The operation was successful in 46 patients (92 per cent) and unsuccessful in 4 tetraplegics with complete high cervical lesions. We discuss the rationales of this procedure for neurogenic dysfunction of the bladder and present urodynamic changes in the successful and unsuccessful cases. This extensive and, yet, microsurgically anatomical resection of the urethral sphincter is recommended for all refractory paraplegics except for complete tetraplegics with high cervical lesions.
我们在此报告对50例经传统保守治疗（包括使用α-肾上腺素能阻滞剂和清洁间歇性自家导尿）无效的截瘫患者行根治性经尿道前列腺切除术的经验。手术在46例患者（92%）中成功，4例完全性高位颈髓损伤的四肢瘫患者手术失败。我们讨论了该手术治疗膀胱神经源性功能障碍的理论依据，并展示了成功和失败病例的尿动力学变化。对于除完全性高位颈髓损伤的四肢瘫患者外的所有难治性截瘫患者，建议行这种广泛但在显微外科层面上符合解剖学的尿道括约肌切除术。
