The long term results of transurethral division of the external urethral sphincter in the neuropathic urethra with reference to potency

Abstract

Abstract. This paper reviews the 900 patients admitted to the Regional Paraplegic Centre in Liverpool from 1956 to 1980. The operation of division of the external sphincter, first described by Cosbie Ross in 1956, was found to be indicated in 143 of these patients with neuropathic outflow obstruction, and there was no post operative impotence.Key words: The neuropathic urethra; Transurethral division of the external urethral sphincter; potency.

The effect of anteromedian sphincterotomy on penile erections in patients with neuropathic bladder

“…This contrasts with Jameson (1982) who found no loss of sexual potency in 90 patients undergoing 5 and 7 o'clock sphincterotomy. This discrepancy is puzzling.…”

“…It may be that 5 and 7 o'clock incisions enjoy some inherent advantage over anteromedian incision although there is no obvious reason why. Case selection may be a factor since Jameson's (1982) series contains a higher proportion of patients with cervical and dorsal (low risk) lesions than ours. Finally the discrepancy may partly derive from terminology; whereas Jameson (1982) refers purely to sexual potency, we deal only with erections per se.…”

“…Case selection may be a factor since Jameson's (1982) series contains a higher proportion of patients with cervical and dorsal (low risk) lesions than ours. Finally the discrepancy may partly derive from terminology; whereas Jameson (1982) refers purely to sexual potency, we deal only with erections per se. There were patients in our series who had erections (including some where these were lost or diminished post-operatively) but which were never adequate for sexual intercourse.…”

“…Certainly published material indicates that 3 and 9 o'clock incisions are more likely to adversely affect erections than incision(s) made in front of or behind this axis (Table III). It is also suggested that the technique as well as the siting of the incision(s) may be important (Jameson, 1982).…”