Long-term follow-up of sphincterotomy in the treatment of autonomic dysreflexia

✍ Scribed by Anthony R. Ricottone; Kevin Pranikoff; James R. Steinmetz; Georgeann Constantino

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 272 KB
• Volume: 14
• Category: Article
• ISSN: 0733-2467
• DOI: 10.1002/nau.1930140108

✦ Synopsis

Autonomic dysreflexia (AD) is ii syndrome affecting a majority of patients with high spinal cord lesions. An association hetween AD and detrusor-sphincter dy. ynergia (DSD) is often seen Between 19x0 and 19XX we perfommed 51 transurethral sph ncterotomies in 3X patients. Twelve o f these patients underwent procedures primarily for the prevention o f A11 related to bladder distension. This study presents their long-term follow-up.

One patient was lost to !idlow-up secondary to unrelated death; the remaining 1 I patients were followed o n avcragc 117.5 months (94-154) after the initial opcrative procedure. Repcat sphincterotomy was requircd in 9 of I 1 patients (X2%). Six ( 6 6 % ) o f these were performed within 24 months. One patient ( I 1% ) required delayed sphincterotomy greater than 100 months from thc initial procedure. Overall, sphincterotomy was successful in controlling symptoms of AD in 1 0 o f I I (91%) patients. N o major complications were recorded. Sphincterotomy is a safe and effective treatment for AD asstKxited with DSD, however long-term urologic follow-up and management are necessary.