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  • Title: A 10 year review of the endoscopic treatment of 125 spinal cord injured patients with vesical outlet obstruction: does bladder neck dyssynergia exist?
    Author: Al-Ali M, Haddad L.
    Journal: Paraplegia; 1996 Jan; 34(1):34-38. PubMed ID: 8848321.
    Abstract:
    The management of 125 patients with post-traumatic neuropathic bladder and vesical outlet obstruction is described and a policy of endoscopic treatment is suggested. A total of 1652 spinal cord injured patients were treated during the period of 1983-1992. About 8% had an outlet of obstruction which required endoscopic treatment. The outcome of transurethral resection of the external sphincter and/or bladder neck was retrospectively analyzed in 82 patients, and a prospective study was conducted on the other 43 patients. We have demonstrated that patients with a complete spinal cord lesion at any level, and those with a high incomplete lesion (above T-9) have benefited from external sphincterotomy combined with bladder neck resection. We emphasize that patients with a low incomplete lesion (T-9 and below) have benefited from bladder neck resection alone. Bladder neck (internal sphincter) obstruction or dyssynergia may require to be considered in the management of the neuropathic bladder.
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