Radical transurethral resection of the prostate in male paraplegics revisited: further clinical experience and urodynamic considerations for its effectiveness

J Urol. 1987 Jan;137(1):72-6. doi: 10.1016/s0022-5347(17)43876-6.

Abstract

We report our experience with radical transurethral resection of the prostate performed on 89 male spinal cord injury subjects. The over-all success rate of modified sphincterotomy was 90 per cent, although there was a 14 per cent recurrence rate with time. Urodynamically, success was characterized by a statistically significant reduction in the degree of detrusor-sphincter dyssynergia, an increase in vesical compliance and a reduction in detrusor hyperreflexia. These results suggest an effect on the distal sphincteric area by the adrenergic system in the genesis of detrusor-sphincter dyssynergia. It is suggested that radical transurethral resection of the prostate exerts this effect via a surgical sympathectomy, while continence is preserved by the activity of the untouched external urethral sphincter.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Humans
  • Male
  • Middle Aged
  • Paraplegia / physiopathology*
  • Prostatectomy*
  • Urethra / physiopathology
  • Urinary Bladder / physiopathology
  • Urinary Bladder, Neurogenic / physiopathology
  • Urinary Bladder, Neurogenic / therapy*
  • Urination
  • Urodynamics*