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handiman New Member Posts: 8 Post Likes Received: 2 Date Joined: February 2014 Injury: T10 Date Injured: 1983 Member is: Offline Send PM	Sphincterotomy May 4, 2014 17:01:36 GMT -8 Quote Select Post Deselect Post Link to Post Back to Top Post by handiman on May 4, 2014 17:01:36 GMT -8 Hello. Im leaning towards this procedure so i would like to know if anybody on here has one and could give me info. My reflex voiding doesnt work no more and by doing ic im always with an uti. Thanks.....

Lαrα
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Sphincterotomy May 5, 2014 0:33:16 GMT -8

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Post by Lαrα on May 5, 2014 0:33:16 GMT -8

Hey there handiman...ive been reading a little about the procedure and results this morning so ive quoted anything interesting and sourced each so you can take a read.
I hope this is of some help

handiman are you aware that this procedure can cause an issue IF...there is a development in research that provides the option of a 'normal' functioning bladder. You may well have to continue to catheter if the procedure is not reversible...Its just a thought.

For those who dont know:Sphincterotomy.
This surgical process weakens the bladder neck and sphincter muscle to allow urine to flow out more easily. After this surgery, you will urinate involuntarily, and must wear a collection device.

The study below focused on the use of a condom catheter post surgery as a means of voiding. It seems it was found that there was too much residue urine being retained for this to be very effective in bladder management . Due to this a good proportion of the patients went on to convert to a suprapubic catheter.
However, it was concluded that voiding efficiency was improved so the procedure is considered successful.

We reviewed 16 consecutive cases of sphincterotomy performed at our institution during the last 8 years to determine the long-term success rate and outcome of this mode of bladder management.
Of the patients 13 are cervical level quadriplegics and 3 are thoracic level paraplegics who were unable to perform self-catheterization.
Preoperative urodynamics most commonly demonstrated detrusor external sphincter dyssynergia, moderate to severe hyperreflexia and decreased compliance.
Followup ranged from 3 months to 8 years (median 39 months). Only 8 of 16 patients still manage the bladder with a condom catheter, while 8 have an indwelling suprapubic cystostomy tube. Only 1 patient followed for more than 4 years postoperatively still uses condom catheter drainage. The most common reason for conversion to suprapubic drainage was difficulty with the external appliance but other reasons included desire for increased independence, high post-void residual volumes and renal deterioration.
source

This study seemed to highlight the sometimes need for a second procedure but does still confirm that the procedure is, in general, effective.

Mean follow-up was 30 months. Mean hospitalization stay was 5 days.
Mean preoperative post-voiding residue (PVR) was 149mL and postoperative was 176mL. Twenty-nine percent (n=13) underwent new sphincterotomy with a final mean 116mL PVR, and a mean delay before new sphincterotomy of 9 months.
Twenty percent (n=9) underwent other surgical procedure for sphincterotomy fail.

In this series, we observed that surgical sphincterotomy is a well tolerated procedure, but with moderate immediate efficiency about 57%. It requires sometimes second procedure and long term follow-up in order not to fail to recognize stenosis, with best surgical success (80%).
source

I went on to read a further study which went on to mention that the procedure can cause complications such as bleeding and penile dysfunction.
This study does give more statistics on success but there is too much to quote but it is definitely worth a read...
Source

The procedure certainly offers a good degree of success but i would maybe raise some of the issues here with your urologist. It should at least help you make a more informed decision.

wavewolf and dannygilman like this

DJ Administrator STAFF Posts: 8,162 Post Likes Received: 2,829 Date Joined: July 2013 Injury: C6 - ASIA B Date Injured: June 2011 Member is: Offline Send PM	Sphincterotomy May 5, 2014 5:06:09 GMT -8 Quote Select Post Deselect Post Link to Post Back to Top Post by DJ on May 5, 2014 5:06:09 GMT -8 Great info Lαrα, hopefully that'll help handiman make a decision!

Lαrα Global Moderator STAFF Posts: 7,350 Post Likes Received: 3,100 Date Joined: August 2013 Injury: CES Date Injured: March 2011 Member is: Offline Send PM	Sphincterotomy May 5, 2014 10:47:48 GMT -8 Quote Select Post Deselect Post Link to Post Back to Top Post by Lαrα on May 5, 2014 10:47:48 GMT -8 May 5, 2014 5:06:09 GMT -8 DJ said: Great info Lαrα, hopefully that'll help handiman make a decision! Thankyou DJ for saying, i hope so too

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Sphincterotomy

Post by handiman on May 4, 2014 17:01:36 GMT -8

Post by Lαrα on May 5, 2014 0:33:16 GMT -8

Post by DJ on May 5, 2014 5:06:09 GMT -8

Post by Lαrα on May 5, 2014 10:47:48 GMT -8

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