[Analysis of 278 sphincterotomies of the urethral stria in 232 male patients].

The authors report 278 external sphincterotomies performed on 232 male neurological patients, presenting with specific etiologies requiring surgery: vesico-ureteral reflux (33.6%), ureterohydronephrosis (18.9%), and spontaneous hyperreflexia (7.4%). The level of the spinal cord injury was superior to T8 in 32.3% of cases (double the corresponding figure for paraplegic patients) and inferior to L1 in 31.2% (25% more than for paraplegics). Short-term results are good in 70% of cases, in terms of dysuria and infection. Iterative sphincterotomy is required in 19.8% of cases, and surgery of the neck of the bladder is required in 34.8%. In the medium term, 83.7% of the good results show an improvement. Continence is achieved in 14.4%, and 12.2% of the patients are incontinent. The mortality rate was 1%, and 10% of the patients suffered from postoperative hemorrhage. Long-term results show 3.2% of secondary impotence, and 10% of patients requiring urinary diversion.