Radiology, Vol 187, 557-560, Copyright © 1993 by Radiological Society of North America
Transurethral balloon dilation of the external urinary sphincter: effectiveness in spinal cord-injured men with detrusor-external urethral sphincter dyssynergia
MB Chancellor, S Karasick, S Strup, CK Abdill, IH Hirsch and WE Staas
Department of Urology, Jefferson Medical College, Philadelphia, PA 19107.
The authors investigated balloon dilation as a minimally invasive
alternative to transurethral external sphincterotomy for the treatment of
detrusor-external urethral sphincter dyssynergia (DESD). Seventeen spinal
cord-injured men with voiding pressures greater than 60 cm H2O underwent
balloon dilation of the external sphincter to 90 F at 4 atm of pressure for
10 minutes. The mean voiding pressures before and 12 months after dilation
were 83 cm H2O +/- 35 and 37 cm H2O +/- 15, respectively (P = .008). There
was a significant decrease in residual urine volume, from 163 mL +/- 162 to
68 mL +/- 59 (P = .05), whereas bladder capacity remained relatively
unchanged at 253 mL +/- 181 and 230 mL +/- 97 (P = .30). Complications
included one case of postoperative bleeding necessitating transfusion, two
treatment failures, and one bulbous urethral stricture. Fourteen of the 17
patients (82%) now void without the aid of an indwelling catheter or
alternative therapy. Balloon dilation has no detrimental effect on erectile
function and may improve fertility.
