Radical Transurethral Resection of the Prostate in Male Paraplegics Revisited: Further Clinical Experience and Urodynamic Considerations for its Effectiveness

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.