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Sexual impotence: a complication of external sphincterotomy


Urologia Internationalis 32(4): 336-347
Sexual impotence: a complication of external sphincterotomy
In paraplegic patients with upper motor neuron lesions, untreated detrusor-sphincter dyssynergy is likely to lead to chronic retention, detrusor hypertrophy, diverticulosis, stone formation and vesicoureteral reflux. Endoscopic sphincterotomy is a commonly used procedure to lower sphincter resistance and facilitate voiding. The technique yields 95% satisfactory clinical results. Temporary or permanent loss of erections after sphincterotomy was however reported. The 3 and 9 o'clock incision and resection appear to carry a higher risk (30-60%) than operations performed at the 1 and 11 o'clock or the 12 o'clock position (0-6%). Impairment of erectile reflex activity is more frequently observed in cases with severe intraoperative bleeding requiring deep coagulation and in the event of reoperation. The clinical, radiological and urodynamic findings of a series of 47 cases (3 and 9 o'clock resections) is presented. Partial and/or temporary inhibition of erection was observed in 5, total and permanent loss in 1 patient.


Accession: 006408677

PMID: 929777

DOI: 10.1159/000280149



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